What is Herniorrhaphy?
Herniorrhaphy is the surgical operation done to repair an
indirect or direct inguinal hernia. Herniorrhaphy
procedures can be performed by an open technique or a
laparoscopic technique.
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Effects of Herniorrhaphy
Herniorrhaphy or any hernia repair procedure is done to
relieve pain, swelling, bulges, and for the prevention of
complications such as restricted blood flow or blocked
intestines.
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Candidates for Herniorrhaphy
Herniorrhaphy is recommended for those who have large
bulges through a small hole (due to restricted blood flow or
blocked intestines), painful hernia, or other symptoms that
interfere with lifestyle.
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Your
Consultation
During consultation, the doctor may advise you to stop
taking aspirin and ibuprofen. The doctor will also tell you
whether you need to have blood drawn.
Your physician may suggest you take a sleeping pill the
night before surgery. You should not eat or drink anything
(even water) before the Herniorrhaphy. The doctor will
advise you when to start fasting.
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The Herniorrhaphy
Procedure
There are now various techniques in repairing hernias. Ask
your surgeon for the best procedure for your needs.
The Conventional Method
begins with the surgeon making an incision over the site of
the hernia. Then the protruding tissue is returned to the
abdominal cavity, and the sac that has formed is taken out.
The surgeon then repairs the hole or weakness in the
abdominal wall by sewing strong surrounding muscle over it.
The Tension-free Mesh Technique
starts off by making an incision at the site of the hernia
and then a piece of mesh is inserted to cover the area of
the abdominal wall defect without sewing together the
surrounding muscles. The recovery from this technique is
fast and the chance of recurrence is low. The mesh used is
safe and generally well-accepted by the body's natural
tissues.
The Laparoscopic Method
involves the use of a laparoscope, a long metal tube with a
fiber optic light source and a telescopic eyepiece, which is
attached to a TV monitor. This technique begins by
inserting the laparoscope into the abdominal cavity through
a small incision and is then used to view the hernia in the
abdominal wall while the surgeon repairs the hernia through
additional tubes inserted into the abdomen through separate
incisions. A general anesthetic is usually required for
this technique.
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Recovery
Pain varies in different patients, and discomfort depends
on the location and type of hernia repaired, as well as the
technique used for the repair. There would usually be a
slight difficulty in walking for the first few hours after
the operation, as well as climbing the stairs for the first
couple of days after the procedure. Make sure to not wet
the incision site during bathing. Sexual activity is also
discouraged for the first week or two. Your surgeon will
advise you regarding heavy lifting, jogging, or doing
strenuous exercise depending on the type and degree of
difficulty it took to do the repair. You should be able to
drive your car within a few days after the repair. Recovery
period lasts from 1 to 6 weeks.
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Risks
The risks in such repairs include infection and bleeding.
In this operation, there is also a risk of injury to the
intestine or bladder. Scar tissue can also develop.
Antibiotics will be prescribed for any infection.
Also, since the laparoscopic method of hernia repair is
relatively new, the complications are not yet well-defined
as the complications associated with the other methods of
Herniorrhaphy.
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Frequently Asked
Questions
Q: What
are inguinal hernias?
A:
Inguinal hernia is the most common type of hernia and it has
an occurrence rate of about 25% in men and 2% in women.
There are two types of inguinal hernia, direct hernia and
indirect hernia. The direct hernia develops when the
intestine passes through the muscle layers of the abdominal
wall into the groin. While an indirect hernia occurs when
the intestine passes through the groin and goes down into
the scrotum.
Q: What
are the signs and symptoms of inguinal hernia?
A:
Symptoms of inguinal hernias differ. The onset is sometimes
gradual, having no other symptoms other than the development
of a bulge. Other times, the hernia will occur suddenly
with a feeling that something has "given way," coupled by
pain or discomfort.
Signs and symptoms of inguinal hernias include visible
bulges in the scrotum, groin, or abdominal wall; a feeling
of weakness or pressure in the groin; a burning feeling at
the bulge; and lastly, a gurgling feeling.
Q: What
causes inguinal hernia?
A:
Most inguinal hernias in adults occur due to the strain on
the abdominal muscles, which are weakened by age or by
congenital factors. The types of activity associated with
the appearance of an inguinal hernia include chronic
constipation causing a strain on the abdomen while on the
toilet; gains in weight causing an increase in pressure on
the abdominal wall; lifting heavy objects; repeated attacks
of coughing; and finally, sudden twists, pulls or muscle
strains.
Q: What
happens if a hernia is left untreated?
A:
A hernia is not dangerous in itself but there is a risk of
it getting strangulated and even cut off the blood supply to
the hernia that may cause fatal conditions like gangrene and
peritonitis. A hernia that is not treated is likely to get
larger and become more uncomfortable, and this may result in
bowel obstruction.
Q: How
can I prevent hernias?
A:
Prevention of congenital indirect hernias is not possible.
But prevention of direct hernias is possible, as well as
reducing the risk of recurrence of direct and indirect
hernias just by maintaining body weight suitable for age and
height; strengthening abdominal muscles through regular
exercise; reducing abdominal pressure by avoiding
constipation and build-up of excess body fluids, achieved by
adopting a high-fiber, low-salt diet; and lifting heavy
objects in a safe, low-stress way, using arm and leg
muscles.
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