Inguinal Hernias are the commonest groin hernias. There are two types of inguinal hernias; Indirect & Direct. An indirect hernia occurs when there is weakness at the point of spermatic cord (in males) or round ligament (in females) exiting the abdominal cavity. This kind of hernia is more commonly seen in younger patients. A Direct hernia occurs when there is a weakness in the abdominal wall muscles in the groin area. This kind of hernia is seen in older patients.
The commonest symptoms from this hernias are either a lump and / or pain in the groin. The lump appears on straining activities such as coughing, sneezing, laughing or straining at stool. The pain and lump tends to get worse as the day passes and may completely disappear when you lie down. Some patient learn to push the lump back in. When the lump doesn’t disappear easily or is constantly painful, or if you start vomiting and haven’t opened bowels or if the lump increases in sizes at a fast rate or the skin over the hernia looks red you MUST seek urgent medical help.
Mainstay of the treatment of these hernias is an operation. The operation can be an open or a keyhole operation. Mr Jayanthi’s practice is predominantly keyhole. If you are otherwise healthy this operation can be performed as a day case surgery. Use of a trus is not advised.
Laparoscopic (Keyhole) Inguinal Hernia repair
This operation is performed under general anaesthetic and involves a cut above the belly button and 2 small cuts on either side. A camera is inserted through the cut around the belly button and instruments through the smalls cuts. The hernia is brought into the tummy cavity and a mesh is placed to strengthen the muscle weakness. The risks of the operation include bleeding & infection as with any other operation. In particular to this operation, there is a risk of injury to the bowel, bladder and blood vessels. There is a very small risk of a seroma (fluid collection – usually self limiting and does not require any treatment) and chronic groin ache. This chronic groin ache is possibly due to nerve damage at the time of the operation (sometimes from metallic tacs) and the risk is very small after a keyhole operation. Mr Jayanthi uses sutures instead of metallic tacos which further decrease the risk of chronic groin pain. There is even smaller chance of the hernia coming back – however the risk is very small.
After the operation
You are expected to get out of the bed and move around as soon as possible after the operation. The vast majority of the patients go home the same day of surgery. Small minority of the patients, especially those who are already having bladder problems such as enlarged prostate may not be able to pass urine and may need temporary catheterisation. You are not allowed to drive for 2 weeks. After the 2 weeks, take your car for a drive in a familiar area at a quite time. If you can change gears (if you drive manual) and do an emergency stop without thinking of the scars or the operation, you are ready to drive. However, you must ease back into driving. Mr Jayanthi will see you in the clinic after about 6 – 8 weeks in the clinic.
This rarer variety of hernia and is commoner in females. This kind of hernia is at an increased risk of complications and much always be treated with an operation. Mr Jayanthi undertakes key hole operation for Femorarl hernias. The operative and post-operative details are similar to that of Inguinal hernia.