Inguinal (Groin) Hernia Repair
Inguinal or groin hernias are the most common type of hernia in adults. Inguinal hernias are more common in men, although they may also occur in women. When a person has an inguinal hernia, abdominal organs, most commonly the small intestine or omentum (a layer of abdominal fat that coats the abdominal cavity), may protrude through the hole or weakness in the abdominal wall and create a visible lump or bulge. The hole or weakness in the abdominal wall is caused by an erosion of a specific layer of the abdominal wall, namely the fascia. The erosion of the fascia is usually caused by wear and tear of the abdomen, leading to a hole (much like a bulge that forms in a tire from the wearing away of the tire’s outer layer). A hernia is truly a hole in the abdominal wall fascia.
Inguinal hernias can be repaired laparoscopically (first video below) or with the assistance of a surgical robot (lower video).
Dr. Lublin Narrates an Actual Laparoscopic Inguinal Hernia Repair Surgery
Dr. Lublin Narrates Robotic Inguinal Hernia Repair Surgery
Fascia is a strong sheet of connective tissue that extends from the top of your abdomen (where it meets your chest) down past your groin into the leg. The fascia is your strength layer of your abdominal wall. It is responsible for keeping your abdominal contents in your abdomen. A hernia is a hole in your fascia.
Inguinal hernias can occur on one side or both sides (bilateral inguinal hernia) of the body. Most often hernias present as a painless bulge in the groin. The bulge may become more pronounced with exercise, coughing, straining, or standing. The bulge usually disappears when lying down. A hernia may also lead to discomfort, most commonly, and, less frequently, pain. More serious complications may result if the hernia becomes incarcerated or strangulated.
The size of the hernia does not correlate well with symptoms – meaning that small hernias can lead to pain and discomfort just as likely as larger hernias. Groin hernias will generally tend to increase in size over time.
Hernia repair is the most frequently performed surgery by general surgeons throughout the entire world. More than 1 million hernia repairs are performed annually in the United States. Worldwide more than 20 million hernia repairs are performed each year.
Inguinal Hernia Treatment Options
Do I need to fix my hernia?
Most hernias should be repaired but some hernias do not require surgery. Many hernias are found on routine physical exams by your medical doctor. Generally, if your hernia is small and does not cause any symptoms (asymptomatic), then you may elect not to have surgery. However, once a hernia is diagnosed it will not resolve or repair itself on its own. A hernia is a hole in the fascia of your abdominal wall- fascia cannot fix itself (meaning it will not regrow or replace itself) Dr. Lublin will evaluate each patient and determine individually if you require hernia surgery.
There are few options available for a patient who has a hernia:
- Do nothing – often referred to as watchful waiting
- Use of a truss or hernia belt
- Surgery through an open or laparoscopic approach
Do nothing. If you hernia is small, produces no symptoms, and you do not wish to have a surgical repair, you may be able to just “live with your hernia”. If it does start to cause symptoms in the future, then surgery can be performed.
Truss or hernia belt. If your hernia is causing symptoms and you still wish to avoid surgery, a truss or hernia belt may be helpful. The belt is worn in such a way so as to not allow the abdominal contents to protrude the hernia (in effect, plugging the hole). If it does this well, which is infrequent, hernia symptoms can be alleviated. This treatment is usually ineffective.
Surgical correction is almost always necessary to repair a hernia. Hernias do not heal on their own or “just go away” and cannot be fixed with diet or exercise. The safest, most effective way to repair a hernia is with mesh in a tension-free method. This repair can either be performed laparoscopically (through small incisions) or through an open method.