A hernia, also known as a hernia, occurs when an internal organ or tissue leaves its normal anatomical location and enters a nearby area through a congenital or acquired weakness, defect, or opening. Hernias most commonly occur in the abdomen, with extraperitoneal hernias being the most common. These include inguinal and femoral hernias. Hernia surgery involves surgically repositioning the hernial contents or high-ligating the hernial sac, followed by repair of the defect. Hernia surgery mainly includes traditional herniorrhaphy, tension-free herniorrhaphy, and laparoscopic herniorrhaphy. Traditional herniorrhaphy involves forcibly suturing non-adjacent tissues. The basic principle is to ligate the hernia sac high up and strengthen or repair the inguinal canal wall. However, the suture tension is high, which can easily cause hernia recurrence and severe pain. Tension-free herniorrhaphy uses an artificial polymer mesh (patch) to repair the hernia without tension. It has the advantages of mild postoperative pain, rapid recovery, and low recurrence rate, and is currently the most important method of surgical treatment. Laparoscopic herniorrhaphy is more advantageous for repairing bilateral inguinal hernias, especially those with multiple recurrences or occult hernias. It also has the advantages of minimal trauma, mild postoperative pain, rapid recovery, low recurrence rate, and no local pulling sensation. However, the cost of surgery is generally high. Therefore, it is recommended that patients go to a regular medical institution for treatment, and the doctor will formulate a corresponding surgical plan based on the specific condition.
A hernia, also known as a hernia, occurs when an internal organ or tissue leaves its normal anatomical location and enters a nearby area through a congenital or acquired weakness, defect, or opening. Hernias most commonly occur in the abdomen, with extraperitoneal hernias being the most common. These include inguinal and femoral hernias. Hernia surgery involves surgically repositioning the hernial contents or high-ligating the hernial sac, followed by repair of the defect. Hernia surgery mainly includes traditional herniorrhaphy, tension-free herniorrhaphy, and laparoscopic herniorrhaphy. Traditional herniorrhaphy involves forcibly suturing non-adjacent tissues. The basic principle is to ligate the hernia sac high up and strengthen or repair the inguinal canal wall. However, the suture tension is high, which can easily cause hernia recurrence and severe pain. Tension-free herniorrhaphy uses an artificial polymer mesh (patch) to repair the hernia without tension. It has the advantages of mild postoperative pain, rapid recovery, and low recurrence rate, and is currently the most important method of surgical treatment. Laparoscopic herniorrhaphy is more advantageous for repairing bilateral inguinal hernias, especially those with multiple recurrences or occult hernias. It also has the advantages of minimal trauma, mild postoperative pain, rapid recovery, low recurrence rate, and no local pulling sensation. However, the cost of surgery is generally high. Therefore, it is recommended that patients go to a regular medical institution for treatment, and the doctor will formulate a corresponding surgical plan based on the specific condition.
Applicable people
Hernia surgery is suitable for patients with inguinal hernia, femoral hernia, etc.
Taboo groups
1. There is severe systemic infection or purulent inflammation at the surgical site.
2. Patients with severe coagulation disorders or bleeding diseases.
3. Patients with poor general condition or severe systemic diseases who cannot tolerate surgery.
4. For those whose hernia is not serious and tends to heal on its own, for example, most umbilical hernias in children can heal on their own within 2 years of age.
Technical/surgical risks
1. Seromas and hematomas: These are relatively common after surgery, occurring in approximately 1%-3% of cases. Seromas result from interstitial fluid leakage from the surgical cavity due to irritation from the patch, lymphatic leakage from intraoperative damage to lymphatic vessels, and interstitial fluid leakage from spermatic cord compression resulting in blood flow obstruction. Seromas are also related to the size and residual size of the hernia sac, leading to the formation of fluid accumulation in the hernia sac. Hematomas are primarily related to bleeding and vascular damage in the surgical area. Once a seroma or hematoma is discovered, it should be actively explored and treated to stop bleeding.
2. Postoperative pain: Postoperative pain is a common complication after hernia surgery. Pain caused by the trauma of the surgery itself usually subsides within two months after surgery as the tissue repairs itself. Clinically, the pain manifests as paroxysmal pain, burning pain, sharp, irritable pain, and radiating pain in the perineum. The pain can occur along specific nerve distributions. Some pain is related to body position and lower limb movement, and some men may even experience testicular pain and painful ejaculation. Patients experiencing postoperative pain can take analgesics under the guidance of a doctor to alleviate symptoms.
3. Peripheral organ damage: This is mainly caused by intraoperative injury. Common organ damage includes spermatic cord vessels, bladder, intestines, blood vessels, and nerves. Therefore, doctors should be cautious during surgery to avoid the above-mentioned situations as much as possible.
4. Patch infection: This is primarily related to intraoperative aseptic technique and the patient’s immune system. Patients may experience localized redness, purulent discharge, or wound dehiscence. If this occurs, antibiotics should be administered promptly, and if necessary, drainage and patch removal should be performed.
5. Hernia Recurrence: Traditional hernia repair involves forcibly suturing non-adjacent tissues. Due to the high tension, hernia recurrence is prone to occur. The recurrence rate for tension-free hernia repair is approximately 1%-4%. High-risk factors for recurrence include age (over 50 years old), smoking, obesity, size of the abdominal wall defect, varicose veins, steroid use, and hereditary collagen metabolism disorders. Adequately securing the patch during surgery and avoiding residual hernia rings can reduce the recurrence rate to a certain extent.
6. Others: such as urinary retention, patch displacement, patch rejection, etc.
Postoperative care
After hernia surgery, attention should be paid to local care, medication management, diet conditioning and lifestyle behavior management.
1. Local care: Keep the incision clean and dry, and pay attention to whether there is bleeding. If there is bleeding, the dressing should be changed in time.
2. Medication management: Use antibiotics as directed by your doctor to prevent infection. If the abdominal incision is painful, take analgesics as directed by your doctor.
3. Diet adjustment: You can drink water appropriately after the gas is discharged. If there is no discomfort, you can gradually add liquid food with less residue, such as rice paste and rice porridge, and then change to lighter soft food, and then gradually return to a normal diet.
4. Behavioral Management: Patients should lie supine after surgery, and may adopt a semi-recumbent position for 2-3 days. Activity can be gradually increased, but strenuous physical labor and excessive exercise should be avoided within 3 months. If pain, redness, swelling, abdominal distension, or pain develop after surgery, the patient should be promptly reviewed by a doctor.
Preoperative precautions
1. Communicate with the doctor to understand the complete process, possible effects and risks of hernia surgery, and sign the informed consent form for anesthesia and surgery.
2. Complete preoperative examinations, such as blood routine, coagulation function, liver and kidney function, electrocardiogram, abdominal ultrasound, etc., to rule out surgical contraindications.
3. Quit smoking 2 weeks before surgery.
4. Stop taking aspirin and other anticoagulants one week before surgery as directed by your doctor.
5. Change to liquid diet one day before surgery, take oral laxatives, and perform cleansing enema if necessary.
6. Do not eat or drink for 4-6 hours before surgery.
7. Cooperate with the doctor to remove hair in the surgical area and place a urinary catheter.
8. Practice urination and defecation in bed.
Surgical procedure
Hernia surgery mainly includes traditional hernia repair, tension-free hernia repair, laparoscopic hernia repair, etc. Here we take laparoscopic repair of inguinal hernia as an example. The surgical process mainly includes inserting laparoscopic instruments, resetting the hernia sac, placing patches, etc.