Before we talk about treatment, let's start with a discussion about the human body and
about your medical condition. Your doctor has told you that you have a hernia. But what
does that actually mean?
In general terms, we can say that a hernia occurs when the layers that make up the abdominal
wall weaken. In other words, the fabric of muscle and other tissues which protect the
gut, develops a defect, or weakness. Through that defect the peritoneum (PER-IT-TA-NEE-UM)
- and perhaps other organs - push their way outward, forming a lump which can be felt
- and sometimes seen - protruding from the abdomen.
During normal childhood development, boy's testes slowly descend from the interior of
the abdomen, down into the scrotum. They pass through the abdominal wall by way of a natural
passageway called the inguinal canal.
In men, the inguinal canal contains blood vessels that supply the testes, as well as
the vessel that carries sperm to the penis. Hernias that occur due to a weakness in the
abdominal wall at the inguinal canal, are called inguinal hernias.
And not surprisingly, men are 25 times more likely than women to experience a hernia in
this area.
Some inguinal hernias press directly through the floor of the inguinal canal.
Others follow the route taken by the blood vessels that supply the testes. This kind
of hernia - called an indirect hernia - can even push all the way into scrotum.
... and finally make their appearance when the abdominal wall is under somewhat less
dramatic pressure. Pregnancy, constipation, straining during urination - even repeated
coughing - any of these actions can, in fact, put enough pressure on an abdominal weak spot
to cause a hernia.
Symptoms of hernias can vary. If you have a mild hernia, you may not even be aware of
Hernias become more serious problems if abdominal contents - such as part of the small intestine
or another organ - slide into the hernia sack and become trapped there.
If those organs cannot slide easily back into the abdomen,the hernia is said to be irreducible.
Irreducible hernias are often painful and can lead to complications.
For example, if the intestine becomes trapped in the hernia sack it is said to be incarcerated.
If the neck of the hernia sack actually pinches off the supply of blood to those organs which
have become trapped inside, the hernia is said to be strangulated.
especially a strangulated hernia can lead to very severe illness and even death.
Luckily, the vast majority of hernias are not considered to be emergencies. However,
if you should ever feel a sudden onset of severe pain in your hernia, you should definitely
seek immediate medical attention.
On the day of your operation, you will be asked to put on a surgical gown.
You may receive a sedative by mouth and an intravenous line may be put in.
You will then be transferred to the operating table.
The surgeon will then apply antiseptic solution to the skin over the hernia, place a sterile
drape around the operative site and will inject a local anesthetic. Usually, the surgeon will
inject more than one spot - to make sure that the entire area is thoroughly numb.
Or in the case of a spinal, the anesthetic will be injected into the small of your back.
After allowing a few minutes for the anesthetic to take effect,
After allowing a few minutes for the anesthetic to take effect, the surgeon will make a shallow
incision 3-5 inches in length, directly over the hernia.
The next incision dissects through the inguinal canal itself and reveals the hernia sack,
which is simply the peritoneum that lines the inside of the abdomen.
The surgeon gently pushes the contents of the sack back into the abdomen.
Next, the opening at the neck of the peritoneum is tied and the hernia sac is removed.
The inguinal canal itself is closed with sutures. These dissolve over time and do not need to
be removed. Any defect or weakness in the muscle tissue needs to be repaired in order
to reduce the risk of reoccurrence.
Occasionally, the surgeon will use a mesh patch to help reinforce this area
Then the muscle layers and other tissues are sewn together and the skin is closed with
sutures or staples.
Finally, a sterile dressing is applied