INGUINAL HERNIA

Inguinal hernias, more commonly referred to as groin hernias, occur when your intestines are pushed through a weakness or tear in an area of the abdominal wall known anatomically as the inguinal canal, thus creating a bulge.

 

Inguinal hernias are by far the most common type of hernia. Since inguinal hernias are typically a result of the testis descending from the abdomen into the scrotum, these types of hernias are found in men more than women at a rate of about 10 to 1.

Inguinal hernias are typically located in the area between your abdomen and thigh and can occur on one side or both sides (bilateral) of the body. Often present is a painless bulge in the groin area. Inguinal hernias are typically more visible when straining or coughing and may disappear when lying down. The presence of discomfort or pain in this area and the inability to push the bulge back into the abdomen often means the hernia may have become incarcerated or strangulated, and you should seek medical attention as soon as possible.

Diagnosis of an inguinal hernia depends, in part, on your medical history and also the doctors' findings upon examination of the groin. Although some serious advances have been made in the medical field in recent years, no tests are needed to diagnose a hernia.

Inguinal hernias can be acquired as the result of sudden or repetitive strain, pressure or injury which weakens the abdominal wall. However, inguinal hernias can also be congenital, or present since birth.

Typically accompanied by a bulge in the groin area, inguinal hernias progressively increase in size and grow more and more uncomfortable as time goes on. In some cases, there is no visible bulge present, but rather mild pain in the groin area characterized by aching or burning sensations. This pain can be felt in the groin region, but may also be present in the leg, back and even pubic areas as a result of referred pain which may only lessen with rest but will not completely go away.

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Inguinal Hernia Surgery

Surgical correction is necessary to repair an inguinal hernia. Inguinal hernias do not heal on their own or "just go away" and cannot be fixed with some sort of diet or exercise. The safest, most effective hernia repair is with mesh in and the advanced "tension free" mesh technique as practiced here at the Hernia Center of Southern California for over ten years. This advanced technique is ideal for inguinal hernia repair surgery in addition to many other types of hernias.

As opposed to the "tension" method first used back in the 1800's, the highly advanced "tension free" mesh technique reduces the chance of recurrence to only 1 in 200, or 0.5%, provides shorter recovery time and greatly reduces post-operative pain. Although some "tension" methods are still in use today, we at the Hernia Center of Southern California believe in, stand behind and practice only highly advanced "tension free" hernia repair. The "tension free" technique involves the placement of synthetic mesh in the inguinal area to repair and strengthen, where as the old "tension" method involved sewing the edges of the weakness or tear back together - sometimes with muscle, sometimes not - without any reinforcement.

With the "tension free" technique, we are able to tailor surgery more to the individual by selecting appropriate mesh for the shape, size and location of the individual hernia. As each of you in a unique individual, so is your hernia. We understand there is no such thing as "one size fits all" and your hernia shouldn't be handled by any type of less effective approach. The basis behind our "tension free" approach is not to create unnatural tension - where it so obviously failed before - by cutting and sewing muscles into new places, but rather to avoid tension entirely.

By making effective use of sterile, flexible polypropylene mesh to reinforce and support the surrounding tissue we are able to effectively repair primary and recurrent inguinal hernias as well as most other abdominal wall hernias. The mesh assists the new tissue growth, almost like a lattice assists flowers or plants in that it acts a stable platform for the new growth to come together and strengthen upon, as it incorporates itself safely and easily into your abdominal wall. Incredibly flexible and thin, you are unable to feel the mesh and it does not inhibit activity at all after surgery. Extending beyond the edges of the original weakness or tear, the mesh also supports the weak, thin tissue surrounding the hernia where it is most effective and will not lift or separate later with strenuous physical activity or excessive abdominal strain.

We have perfected our surgical techniques in such a way that we are even able to test and maximize the strength of the hernia before surgery is complete. Our proprietary methods enable you to return to everyday activity quicker and we guarantee surgery FOR LIFE. Not only that, but our surgical methods are:

  • Safe
  • Effective
  • Fully Approved
  • Designed for Fast Return to Everyday Activity
  • Provide Minimum Post-Operative Pain
  • Less Physically Restrictive
  • Achieve High Patient Satisfaction

Understanding your unique situation and needs is first and foremost for us at the Hernia Center of Southern California, which is why we don't perform one type of inguinal hernia surgery on everyone, but rather choose methods best suited to you. Our philosophy carries over into our surgical techniques allowing us to specially to perform an inguinal hernia repair your hernia in a way best suited to our hernia specialists findings during surgery. We offer our advanced surgical techniques to you with the reassurance you are receiving the best possible care and repair for your hernia. Since our inguinal hernia surgery techniques are "tension free" your risk of post-operative pain, problems, and recurrence is extremely low and you can rest assured you will be returning to your regular, everyday activities with fewer restrictions, quicker.

Inguinal hernia surgery is generally performed under a local anesthesia with sedation and patients are typically allowed to return home the same day, often requiring little or no medication. Since our surgeons and staff here at the Hernia Center of Southern California are fully trained in our advanced surgical techniques for abdominal hernias, we encourage patients to walk and move immediately after surgery in every effort to return you to your everyday activities within days, minimizing your down time and any additional inconveniences.

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INGUINAL HERNIA SURGERY


Inguinal hernia surgery involves repair of the abdominal wall, returning the hernia and its contents internally back to into normal position and closing the defect in the abdominal wall with a non-reactive mesh. The type and size of mesh will be individualized separately for each patient by the surgeon at the time of surgery in order to achieve the best possible result. We have extensive experience performing inguinal hernia surgery to suit each individual hernia with the added experience of having performed over 7,500 hernia operations. The surgical technique we use for inguinal hernia repair is called the Tension Free Mesh technique. This technique, along with our experience, ensures that your surgery is safe and successful with minimal discomfort. In most cases, inguinal hernia surgery will be performed under local anesthesia with sedation.

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Local Anesthesia with Sedation

This is our preferred method of anesthesia. In fact, 90% of our patients receive this method of anesthesia. In the operating room you will receive only one simple stick for starting the intravenous line while you are awake. You are then given the anesthetic medications through the intravenous line so that you will not feel any pain. You are given medication for pain and to relax you. You will very gradually drift into a pleasant sleep. Once you are asleep the local anesthesia is given. The substance used for local anesthesia is similar to the Novacain your dentist may use, however, we use a combination of two medications. One is Lidocaine, a short acting local anesthetic that will insure you a pain free surgery. The second medication is Marcaine with Epinephrine, which is a long acting local anesthetic. Marcaine will provide local anesthesia that will last up to four or six hours. Therefore, after your inguinal hernia surgery you will be pain-free for several hours so you can return to the comfort of your home. When you wake up at the end of the inguinal hernia surgery you are still in the operating room. The operating room staff will assist you to walk to the recovery room.

Since you are asleep there is no pain at the time of the initial local anesthetic injection and no pain at the time of inguinal hernia surgery. This is our preferred method of anesthesia because it is pain-free, very safe, and has a minimal amount of side effects. This method lacks the side affects of general anesthesia which can, on occasion, cause sore throat, headache or vomiting. With this method patients are minimally disoriented.

Patients are discharged the same day as inguinal hernia surgery with a prescription for pain pills. After a couple of days most patients will require only over-the-counter pain pills and will be able to return to their normal daily activities, including driving. All patients will experience numbness in the region of the inguinal hernia surgery.

Since we are experienced in inguinal hernia repair, we are considered true hernia specialists. Due to our knowledge and expertise in the field of inguinal hernia repair, our results are better than the national average, however, we are required to inform our hernia patients regarding the complications of inguinal hernia surgery. The results of the national average are listed below.

•  Recurrence of the Hernia*....................................0.5% or 1 in 200.
*(Recurrent hernia usually occurs in obese patients or in patients who have already undergone a prior hernia repair.)
•  Infection of incision ..............................................0.5% or 1 in 200
•  Bleeding after surgery..........................................1% or 1 in 100
•  Change in testicular size and function...............1% or 1 in 100
•  Injury to the bowel, bladder or bowel .........0.025% or 1 in 400
•  Injury to the Vas deferens ............0.025% or 1 in 400
•  Temporary chronic incisional pain lasting 2-3 months................................3 to 5% or 3-5 in 100
•  Mild chronic incisional pain w/neuroma formation, non-dehabilitating ....1% or 1 in 100
•  Chronic incisional pain w/neuroma formation can be dehabilitating ....0.5% or 1 in 200
•  Temporary swelling, or black and blue after surgery, lasting about 1 week*.... 10% or 1 in 10
*(This is not considered a complication)

Most of the numbness will gradually resolve as the nerves regenerate. However, in most instances, there will be a small area the size of a quarter just below the incision where the numbness will be permanent. The numbness will be barely noticeable and will not alter any normal function. Numbness is not considered a complication. Patients with recurrent hernias have a higher complication rate than patients who are undergoing their surgery for the first time.

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