Inguinal Hernia Surgery

Inguinal hernia is more commonly seen in men compared to women. It is also known as a groin hernia. It occurs when the fat from the abdomen or intestines protrudes through the lower part of the abdominal wall into the groin.

The condition may be seen in the right or left inguinal canal (a passage that is present on each side of the lower abdomen and connects to the genitals).
An inguinal hernia could lead to complications like incarcerated hernia (when the contents of the hernia become trapped in the abdominal wall leading to bowel obstruction) and strangulated hernia (a life-threatening condition in which the blood supply to the intestine is cut off).

Types:
Based on the type of surgery performed, inguinal hernia surgery can be of the following types:

1. Herniotomy: It involves the excision of the band of tissue constricting the protruding structures and then pushing them back into their place.
2. Herniorrhaphy: Herniotomy is followed by suturing or stitching the defect in the abdominal wall.
3. Hernioplasty: It involves providing additional reinforcement to the defect in the abdominal wall after repair using a synthetic mesh.

Risk factors:

Certain factors may increase the risk of developing an inguinal hernia and may include the following:

• More common in men
• Old age
• White race
• Family history
• Chronic or long-term constipation
• Chronic cough
• Pregnancy
• Premature birth
• Low birth weight
• History of inguinal hernia
• History of hernia repair surgery 

Symptoms

Symptoms :

The following symptoms are associated with an inguinal hernia:

• Heaviness or pressure on the groin
• Bulge in the area on either side of the pubic bone, which becomes more apparent on standing upright, coughing, or straining
• Aching sensation or burning at the bulge
• Pain or discomfort in the groin region, especially when coughing, lifting, or bending over
• Pain and swelling around the testicles (rare)
• Symptoms in children may include the following:
• Visible bulge when coughing, crying, standing for a long time, or straining during a bowel movement
• Irritability
• Loss of appetite 

Causes:
Certain inguinal hernias have no apparent cause. Other types of inguinal hernias may occur due to:

1. Increased abdominal pressure
2. Pregnancy
3. Pre-existing weak spot in the wall of the abdomen
4. Straining during urination or bowel movements
5. Strenuous activity
6. Chronic sneezing or coughing

Diagnosis

The following tests may be recommended before an inguinal hernia surgery:

1. Physical examination: The doctor will check the patient’s abdomen and check for the presence of any bulge on standing, coughing, or straining. The patient’s medical history and symptoms are also evaluated by the doctor.
2. Blood tests: Underlying medical conditions may be detected using blood tests.
3. Chest x-ray: It helps the doctor in checking the condition of the heart and lungs.
4. Electrocardiogram (ECG): The electrical activity of the heart can be measured using an ECG.
5. Imaging tests: The doctor may recommend imaging tests such as CT scans, MRI scans, or abdominal ultrasounds to obtain clear images of the abdomen.

Treatment

Inguinal hernia surgery may be performed under local anesthesia (the treatment area is numbed) or general anesthesia (the patient is put to sleep during the procedure). The procedure can be performed using one of the following techniques:

1. Open surgery:

• This type of surgery is performed in cases of large hernias.
• The surgeon makes a large incision or cut in the abdominal area.
• The surgeon will then perform the procedure of herniotomy, herniorrhaphy, or hernioplasty to repair the hernia.
• The incision made is then closed using sutures or staples.

2. Laparoscopic surgery:

• This is a minimally-invasive procedure recommended in cases of small hernias.
• The procedure involves making several small keyhole incisions in the abdomen.
• Certain special surgical instruments are inserted through the incisions made. One of these instruments is a thin tube having a camera on one end, called a laparoscope, through which the surgeon can view the surgical site and perform the procedure.
• Hernia repair is carried out by the surgical instruments inserted.
• A mesh may sometimes be inserted to increase the strength of the weakened abdominal wall through which the herniation has occurred.
• After the completion of the procedure, the incisions are closed using sutures.
• The procedure involves lesser scarring, lesser pain, and quicker recovery compared to open surgery.

3. Robot-assisted surgery:

• The surgery is performed using a laparoscopic technique.
• It is performed by robotic arms that are guided by the surgeon.
• The procedure offers greater precision compared to the other techniques used.

Risks

Inguinal hernia surgery may have the following complications:

• Pain
• Infection
• Bleeding
• Allergic reaction to the anesthetic agent used
• Blood clot formation
• Fluid or blood build-up in the space left by the hernia
• Blood vessel damage
• Nerve damage
• Recurrence of hernia
• Damage to the surrounding organs or tissues, like the testicles

After Procedure

• You can usually go home on the same day after the surgery. If you have any complications, you may need to stay for a longer time in the hospital.
• Some men could have trouble passing urine after the surgery and may need a catheter (a thin, flexible tube) inserted into the bladder for a short period to drain urine.
• You should eat a healthy, high-fiber diet after the surgery to avoid constipation.
• Drink lots of fluids throughout the day.
• Avoid heavy lifting and strenuous activities for a few weeks after the surgery.
• Follow your doctor’s instructions on how to care for the wound.
• Most patients can resume their daily work and light activities within two weeks of the surgery.
• Complete recovery after a laparoscopic procedure may take about two to three weeks.
• Complete recovery following an open surgery may take about four to six weeks.

Home remedies:

The following home remedies may help in relieving the symptoms associated with an inguinal hernia:

• Wearing hernia belts
• Hold the hernia while straining or coughing
• Take light walks or exercise every day
• Do yoga
• Avoid processed foods
• Maintain a healthy weight
• Apply an ice pack to the hernia 
• Eat a fiber-rich diet
• Consume ginger root

Cost:

The cost of inguinal hernia surgery in Mumbai is between INR 68,000 to INR 2,50,000.
The cost of inguinal hernia surgery in Delhi is between INR 65,000 to INR 2,25,000.
The cost of inguinal hernia surgery in Bangalore is between INR 65,000 to INR 2,25,000.
The cost of inguinal hernia surgery in Chennai is between INR 62,000 to INR 2,00,000.