Inguinal hernia is caused when the intestinal tissues push through the weakest part of the inguinal canal causing a bulge in the canal. This makes a hole in the muscle of the inguinal canal. This hole can be classified in to following:
- Indirect inguinal hernia: this is the most commonly found type of inguinal hernia. This occurs mostly in babies that have premature births. In such cases the inguinal canal will not be fully developed and will be weak. In adults it is commonly found in men. In indirect inguinal hernia the hole will be lateral to the blood vessels.
- Direct inguinal hernia: this type is found in adults and the hole will be in the middle from the blood vessels.
- Incarcenated hernia: when the tissues push through the wall of the inguinal canal and be stuck in the groin not able to move back to the position then the hernia is termed as incarcerated hernia.
Strangulated hernia: strangulated hernia is life threatening as they can stop the blood flow to the small intestine.
The inguinal canal is present in the groin. The groin is the junction that joints the abdomen and the thighs. Inguinal hernia can be found in both men and women. In men, the spermatic cord passes through the inguinal canal. In female, the uterus is held in position by the ligaments that pass through the inguinal canal.
Inguinal hernia is usually treated by surgery. Both indirect inguinal hernia and direct inguinal hernia can be treated with open surgery also known as herniorrhaphy. In this procedure the tissues over the weakened muscles are opened and the hernia is located. Then a mesh is placed to support the muscles and to remove the hernia defect.
The Open inguinal hernia surgery usually lasts for about 45 minutes. Doctors instruct on limiting the food intake before the surgery. The surgery begins with a local anesthetic injected into the spine. A single cut is made above the hernia which will be about 6-8cm long. The surgeon then moves the bulge of tissues or the loop of bowel back into the exact position. After repositioning, a mesh is positioned in the abdominal wall to reinforce the muscles. This is to prevent further bulges in the weak spot of the abdomen. Later the cut is stitched and closed.
In open surgery, dual mesh can be provided to support the tissues. By using dual mesh, one side provides support under the muscle and the other side is positioned over the top of the injured muscle tissues. This dual support helps in managing from both inside and outside of the muscle.
In some cases, the hernia becomes strangulated causing damage to the bowel. In such situations the affected segment of the bowel will be removed and the new ends will be joined together. In some cases a stoma may be formed. This is a major operation and requires staying in hospital for few days to recover.