Inguinal hernias, painful bulges in the groin area, are common among children and adults. Small hernias that only cause mild discomfort may not need to be treated, but most problems require one of two types of surgery. A doctor may decide to perform a hernioplasty, during which a mesh material is inserted into the groin region to prevent further bulging. An especially stubborn or recurring hernia may require a more invasive procedure called a herniorrhaphy, wherein a surgeon makes a large incision, manually pushes the bulge back into place, and sutures the surrounding tissue.
Both forms of inguinal hernia repair are usually performed on an outpatient basis at a hospital, surgical center, or specialty clinic. Most surgeries can be completed in about one hour, and patients are usually allowed to leave the facility under their own power shortly following their procedures. A patient who is scheduled for inguinal hernia repair may be asked to show up about an hour before the procedure to fill out paperwork and give the doctor a chance to review previous diagnostic findings, conduct a final physical examination, and explain what will occur.
Inguinal hernia repair can usually be performed under localized anesthetic, meaning the surgeon can numb just the groin area before the procedure. Some surgeons prefer to administer general anesthesia that basically knocks out the patient and prevents him or her from feeling pain. Once anesthesia is administered, the doctor can shave and sterilize the area and begin making the initial incisions.
During a herniorrhaphy, the surgeon usually makes a single, long incision to the side of the pubic bone. He or she pushes bulging tissue back into the abdomen, ensures that intestines are not ruptured or inflamed, and sutures muscle tissue together to strengthen the inner lining of the abdomen. The specialist can then stitch together the surgical scar, apply antibiotic ointment, and assist the patient to a recovery room. Following the inguinal hernia repair procedure, nurses make sure the anesthesia wears off and that the patient does not experience intensive pain.
Preparations and follow-up care for a hernioplasty are similar to those for a herniorrhaphy. Instead of making a large cut, the surgeon will create several small incisions around the bulge. He or she inserts a tiny lighted camera called a laparoscope into one of the incisions which projects a video feed onto a computer screen. The doctor relies on the camera to navigate precision surgical tools around the hernia, pushing it back into place. He or she then inserts mesh material into the cavity through another incision and stitches it to the inner lining of the abdominal cavity to provide extra stability.
Inguinal hernia repair has a high success rate, and most people are back on their feet within hours or days of surgery. They may be prescribed pain management medications or antibiotics to prevent infection, and scheduled for follow-up visits to ensure the success of procedures. With effective treatment, the majority of patients do not experience recurring hernias.