Inguinal Hernias are the most common type of abdominal hernia seen by hernia surgeons. They are located in the groin area and are more common in men. As with all hernias, surgical repair or hernia surgery is required to fix inguinal hernias since they don’t go away on their own.
Many patients ask “what is an inguinal hernia?” or “how does an inguinal hernia form?”. We hope that by reading the information below, that patients can understand more about inguinal hernias.
The Basics Of An Inguinal Hernia:Inguinal hernias, also known as groin hernias, are when the intestines or fat push through the muscles into the inguinal canal. This is the layer of muscles in the groin which houses the spermatic cord in men, or the round ligament in women. The hernia can be directly through the muscle (direct inguinal hernia) or the hernia can follow the round ligament or spermatic cord through it’s indirect path as they exit the abdomen (indirect inguinal hernia).
Up to 75% of abdominal hernias are inguinal hernias. They can be found in men and women, but more commonly in men due to the fact that men have a larger opening in the abdominal wall because of the spermatic cord. Inguinal hernias often develop as small bulge that enlarges over time. The bulge may disappear while lying down and return with activity.
Symptoms Of An Inguinal Hernia:Like most other hernias, pain in the groin is one of the most common symptoms. Also, due to the fat and intestines pushing through the hernia, a bulge can often form under the skin. This bulge can get bigger and smaller depending on what is in the hernia.
Over time, if the hernia gets large enough, the intestine can get permanently trapped, which can lead to damage to the intestine, as well as other symptoms like nausea, vomiting, and constipation.
Read more about symptoms HERE.
How Are Inguinal Hernias Repaired?Since no hernia can heal on its own, surgical repair is required. Options for hernia repair include open surgery, and laparoscopic surgery. Both options are well studied and have excellent outcomes. No one option is right for all patients which is why we feel it is important to offer BOTH to patients. Learn more on our ‘Compare Open and Laparoscopic Surgery‘ page.
A laparoscopic inguinal hernia requires a 1-2cm incision at the belly button, and two smaller punctures below the umbilicus. The belly button incision allows the camera to view the inside of the abdomen and the two smaller punctures are for the operating instruments.
Inguinal hernias are caused by a hole in the muscle of the groin. This hole can either be lateral to the blood vessels (indirect inguinal hernia), or towards the middle from the blood vessels (direct inguinal hernia). Regardless, in open surgery, the muscle layers over the weakened muscle are opened. The hole (or holes) in the muscle are found. A dual sided mesh is used to reinforce the hernia defect and the muscle around the hole.
The dual mesh allows one layer (with the blue circles) to be placed under the muscle, while the other top layer is placed over the damaged muscle. With this type of repair, the weakened muscles are treated from both the inside AND the outside of the hole. This cannot be done in laparoscopic surgery since only an inner layer mesh can be used.
Laparoscopic Inguinal Hernia RepairThis patient had a noticeable bulge in the left groin. He opted for laparoscopic surgery for treatment. The balloon spacemaker (see above) is placed under the muscle but over the intestines. When the balloon is removed, the hole in the muscle is found. A lightweight mesh is placed over the defect to repair the hernia.
Inguinal Hernia Repair Videos
Open Inguinal Hernia RepairDr. Todd S. Harris narrates an open inguinal hernia repair surgery done at California Hernia Specialists’ hernia center.
Laparoscopic Inguinal Hernia RepairDr. Todd S. Harris narrates a laparoscopic inguinal hernia repair surgery done at California Hernia Specialists’ hernia center.
Large Chronic Inguinal Hernias
The vast majority of inguinal hernias that we operate on are small, often the size of a golf ball, or sometimes not even visible under the skin. However, some patients choose to wait to have their hernia repaired until it becomes a major source of pain and negatively impacts their activities of daily living.
In my blog, I shared an article on Giant Inguinal Hernias so I wanted to follow up on that topic with actual cases that we have seen in our office. At California Hernia Specialists, we frequently see patients with complicated inguinal hernias who refer themselves to our center since we specialize in these types of repairs. Although these patients did great after surgery and they are back to normal activities today, I wouldn’t wait as long as they did to have your hernia fixed!
See more pictures of large, long-standing, groin hernias which extended into the scrotum by clicking here.
Patients often ask me if or when they should have their hernia repaired. There is no simple answer except there are a few basic rules of thumb as to when to have surgery for your hernia:
- if the hernia begins to limit your activities
- if the hernia is getting larger over time
- if you are having difficulty reducing the hernia back into your abdomen
6 months post surgery
3 months post surgery
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Read more about other complex cases on our ‘Recent Unique Cases‘ page.