Türkçe
ASSOCIATE PROFESSOR SABAHATTİN DESTEK | GENERAL SURGERY SPECIALIST
Inguinal hernia occurs when the inguinal canal remains open in the womb and the lining of the abdomen extends down the inguinal canal. Inguinal hernia can be seen at any age. The incidence is 1-4%. Inguinal hernia is 7 times more common in men than in women and occurs in almost one out of every two people in men over the age of 70. Right inguinal hernia is more common. However, hernias can be seen in both groins.
Inguinal hernias seen in women are mostly femoral hernias. They occur as a result of physical strain such as pregnancy, constipation and coughing.
Abdominal hernias are more common in obese people, people with persistent cough, constipation, heavy workers, heavy lifters, people with rheumatism, kidney failure, rheumatic diseases and cirrhosis patients.
The most common symptom of hernia is swelling in the abdominal wall. The swelling usually becomes more pronounced when standing, and subsides or disappears when lying down. Pain may be observed along with the swelling. Pain is more common especially in small hernias that can get stuck. In cases where the intestines enter the hernia, there may be much larger swellings. If the intestine gets stuck in large hernias, very serious pain, nausea and vomiting may occur. In these patients, intestinal compression and intestinal gangrene may develop, in which case emergency intestinal surgery will be required. Therefore, when a hernia occurs, surgery should be performed without waiting.
Ultrasound is performed in patients presenting with complaints of swelling and herniation in the groin. If the hernia is large and there is an organ in it, abdominal tomography may be performed. The aim is to look for the presence of organs in the hernia or to distinguish the symptoms of other diseases that may occur in the groin.
The aim of inguinal hernia surgery is to repair the damaged abdominal wall. Currently, the most commonly used surgical method is open, patched hernia surgery. The more preferred surgical technique in recent years is closed (laparoscopic) hernia surgery.
In the open method, 8-10 centimeter skin incisions are made depending on the size of the hernia, while 3 tiny incisions of 1 cm are sufficient in the closed method. In laparoscopy, the organs entering the hernia and their condition are more clearly seen.
In the open technique, a patch is placed between the outer layers of the abdominal wall through an incision over the hernia area. In the closed technique, laparoscopic instruments are inserted into the abdomen and a patch is placed in the hernia from the inside.
Closed surgery does not require large skin incisions. The postoperative period is comfortable. Wound healing is faster, pain is less, and the risk of inflammation is very low. Return to daily movements and work is much faster. The rate of development of problems during surgery is reported to be 3-5% on average, but most of these are minor problems. In open inguinal hernia surgery, the hernia is more likely to recur and this rate is 5%. In experienced hands, hernia recurrence after closed surgery is very low.