A hernia is the abnormal exit of tissue or an organ, such as the bowel, through the wall of the cavity in which it normally resides. Hernias can be congenital or acquired. Due to the location, we can distinguish:
- inguinal hernias
- scrotal hernias
- femoral hernias
- epigastric hernias
- umbilical hernias
- postoperative hernias
- recurrent hernias
- hiatal hernias.
It should be remembered that regardless the type of hernia, surgery is the only effective method of treatment. Once a hernia is formed, it will not disappear spontaneously. The delay in diagnosis of hernia may lead to its incarceration. An incarcerated hernia occurs when herniated tissue becomes trapped and cannot easily be moved back into place. Hernia incarceration is an acute condition that may lead to a bowel obstruction or strangulation.
How is a hernia treated?
Hernia repair may be performed as on open or laparoscopic surgery. The decision about the operating method is made by surgeon based on size and location of the hernia, patient’s surgical
Laparoscopic inguinal hernia repair
There are two main methods of laparoscopic repair:
- TAPP – transabdominal preperitoneal repair
- TEP – totally extra-peritoneal repair
In transabdominal preperitoneal hernia repair (TAPP) surgeon reaches the inguinal region through the abdominal cavity, whereas in totally extra-peritoneal technique (TEP) peritoneal cavity is not entered and surgical instruments are placed in preperitoneal space. Once the camera and surgical instruments are placed, the contents of hernia sac are removed. At the end, the inguinal canal wall is forced by introducing the special mesh.
Open inguinal hernia repair
The most commonly performed open surgery for inguinal hernia repair is Lichtenstein technique. The surgeon makes an oblique incision in groin region about 10-cm long and successively cuts the layers to visualize the inguinal canal and identify its elements such as vessel, nerves and spermatic cord in men. Then the hernia sac is returned to the abdominal cavity or excised and the posterior wall of inguinal canal is strengthened. In order to reinforced the inguinal canal, the special mesh is placed and fixed with stiches or glue.