From the Guidelines
Surgical repair is the recommended treatment for an inguinal hernia, as it is the only definitive treatment option that can prevent serious complications like incarceration or strangulation. The decision to operate is based on the risk of complications and the presence of symptoms. Two main surgical approaches are available: open hernia repair and laparoscopic repair. Open repair involves making an incision over the hernia site and either pushing the protruding tissue back into place and strengthening the abdominal wall with stitches (herniorrhaphy) or reinforcing it with synthetic mesh (hernioplasty) 1. Laparoscopic repair is less invasive, using small incisions and a camera to guide the placement of mesh.
Key Considerations
- The use of mesh in clean surgical fields is associated with a lower recurrence rate, without an increase in the wound infection rate 1.
- Local anaesthesia (LA) can be used, providing effective anaesthesia with less postoperative complications for emergency inguinal hernia repair in the absence of bowel gangrene 1.
- Patients should undergo emergency hernia repair immediately when intestinal strangulation is suspected, as early diagnosis and treatment can significantly improve outcomes 1.
Surgical Approach
- Open repair and laparoscopic repair are both effective, but the choice of approach depends on the individual patient's condition and the surgeon's preference.
- Laparoscopic repair may be preferred for patients with a high risk of complications or those who require a quicker recovery time.
- Open repair may be preferred for patients with a low risk of complications or those who have a contraindication to laparoscopic surgery.
Postoperative Care
- Recovery typically takes 1-2 weeks for laparoscopic surgery and 3-6 weeks for open surgery, with restrictions on heavy lifting (nothing over 10 pounds) during this period.
- Patients should be monitored for signs of complications, such as infection, bleeding, or recurrence of the hernia.
- Follow-up appointments with the surgeon are necessary to ensure proper healing and to address any concerns or questions the patient may have.
From the Research
Treatment Options for Inguinal Hernia
The recommended treatment for an inguinal hernia depends on various factors, including the size and type of hernia, as well as the patient's overall health.
- Laparoscopic surgery is a minimally invasive procedure that involves making small incisions in the abdomen to repair the hernia 2, 3.
- Open surgery, also known as herniorrhaphy, is a more traditional approach that involves making a larger incision in the abdomen to repair the hernia 2, 4.
- The choice of treatment depends on the individual patient's needs and the surgeon's expertise.
Comparison of Laparoscopic and Open Surgery
Studies have compared the outcomes of laparoscopic and open surgery for inguinal hernia repair.
- Laparoscopic surgery has been shown to result in less postoperative pain, shorter hospital stays, and faster recovery times compared to open surgery 2, 3.
- However, laparoscopic surgery may be more expensive due to the cost of equipment and technology 3.
- The recurrence rate for laparoscopic surgery is similar to that of open surgery, with some studies suggesting a slightly lower recurrence rate for laparoscopic surgery 2, 5.
Special Considerations
In certain cases, such as recurrent inguinal hernias or hernias in pediatric patients, the treatment approach may vary.