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An inguinal hernia is the protrusion of abdominal tissue from weakened abdominal muscles in the groin area. This can cause a bulge, which is painful in some cases. Left untreated, it can cause discomfort and may even result in serious complications.
The two common types of surgeries for inguinal hernia treatment are – open repair surgery and laparoscopic repair surgery.
The open repair of inguinal hernia surgery also includes three types of surgeries. Depending on the situation or type of hernia, surgeons will decide which open repair surgery will be ideal for the patient.
Herniotomy
Herniotomy involves the removal of the hernia sac, without repair of the inguinal canal. The surgeon may first tie the protruding content, push it back into the abdomen, and then remove the entire hernia sac to prevent hernia recurrence. Typically, this repair is done for children.
Herniorrhaphy
This surgery involves herniotomy (removal of the hernia sac) and strengthening of the posterior abdominal wall. The surgeon will reduce the protruding part back into the abdomen, and then sew the lower muscles of the abdomen where the hernia has developed.
Hernioplasty
The third type of open repair of inguinal hernia is hernioplasty; this involves herniotomy (removal of the hernia sac) and strengthening of the posterior abdominal wall with a mesh. In addition to pushing back the hernia to the abdomen, the surgeon will put on a mesh (patch) which prevents the recurrence of hernias. The mesh helps to reduce the load on the weakened parts of the belly.
In this procedure, a surgeon repairs the herniated region by making small incisions, through which a thin tube, a tiny camera, and a mesh can be inserted. Then, internally the mesh is placed and fixed below the herniated area without needing to make a large cut in the belly.
In experienced hands, the results of laparoscopic repair are comparable to open repair, with similar recurrence rates reported. However, laparoscopic repair surgery is generally preferred in patients with a previous history of open repair surgery of the inguinal hernia as it avoids going through scarred tissues from previous surgery. The minimally invasive method is also associated with reduced pain and fewer peri-operative complications.
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