What is the treatment for inguinal hernia?

There are different ways to treat inguinal hernias. Usually, we fix them with mesh. If we can, we like to place the mesh under the muscle wall. In the groin, there are two commonly used methods. One is an open method (also called the Lichtenstein method), which opens the inguinal canal by making an incision over the top of the inguinal canal. We go down, open the canal up and isolate the spermatic cord. Then we place a piece of mesh on the floor of the inguinal canal to reinforce the hole.

The other way to do this is laparoscopically. There are two different laparoscopic methods. The one that I use is called the total extra-prepared inguinal method. It involves making an incision next to your belly button. Then we go down underneath the rectos muscle and put a balloon between the abdominal wall and the abdominal cavity. Once the balloon is in the space, it's inflated and we dissect this space so we have room to work. Then, we isolate the spermatic cord again, but this time we're on the other side of the abdominal wall. We find the hernial sac and pull it back out of the hernia. Then we cover the hernia with mesh. This time the mesh is on the floor, behind the muscle wall, so it reinforces it from behind.
There is a difference in recovery time between the open procedure and the laparoscopic procedure. Generally, for laparoscopic procedures, you're able to start full activities about one week after surgery. But for an open procedure, that time limit is six weeks.

In adults, inguinal hernias that enlarge, cause symptoms, or become incarcerated are treated surgically. In infants and children, inguinal hernias are always operated on to prevent incarceration from occurring. Surgery is usually performed on an outpatient basis. Recovery time varies depending on the size of the hernia, the technique used, and the age and health of the patient. The two main types of surgery for hernias are as follows:

"Open" hernia repair: In open hernia repair, also called herniorrhaphy, a person is given local anesthesia in the abdomen or spine to numb the area, general anesthesia to sedate or help the person sleep, or a combination of the two. Then, the surgeon makes an incision in the groin, moves the hernia back into the abdomen, and reinforces the muscle wall with stitches. Usually, the area of muscle weakness is reinforced with a synthetic mesh or screen to provide additional support-an operation called hernioplasty.

Laparoscopy: Laparoscopic surgery is performed using general anesthesia. The surgeon makes several small incisions in the lower abdomen and inserts a laparoscope-a thin tube with a tiny video camera attached to one end. The camera sends a magnified image from inside the body to a monitor, giving the surgeon a close-up view of the hernia and surrounding tissue. While viewing the monitor, the surgeon uses instruments to repair the hernia using synthetic mesh.

People who undergo laparoscopic surgery experience shorter recovery times. However, the doctor may determine that laparoscopic surgery is not the best option if the hernia is very large or the person has had pelvic surgery.

Most adults experience discomfort after surgery and require pain medication. Vigorous activity and heavy lifting are restricted for several weeks. The doctor will discuss when a person may safely return to work. Infants and children also experience some discomfort, but usually resume normal activities after several days.

This answer is based on source information from the National Institute of Diabetes and Digestive and Kidney Diseases.

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