Inguinal hernia: what to know

An inguinal hernia is a protrusion of abdominal contents, quite often bowel or abdominal fat, through a weak area in the groin tissue. It is one of the most common types of hernia. The main line of treatment is surgery, which can be conducted with minimally invasive techniques. In this article, a constant general surgeon explains how inguinal hernias occur and what can patients should know about treating them.

What is an inguinal hernia, and what causes it?

The most typical characteristic of an inguinal hernia is a bulge felt in the groin area. In this area is the inguinal canal, which is a passage in the lower abdominal tissues; in men, it is where the spermatic cord is located, and in women, there is instead a ligament that gives structure to the uterus. An inguinal hernia is noticeable both sensorially and visually during strain, such as during a fit of coughing, lifting heavy objects, or sneezing. The bulge becomes more prominent towards the end of the day and can usually be reduced when lying down. Inguinal hernias may not necessarily be painful, but they can be sensitive to touch.

They are caused by a weakness of the abdominal tissue that is worsened by pressure in the abdomen. They are more common in older patients as skin loses elasticity with age. But they can be hastened by repetitive abdominal pressure, like straining during bowel movements, chronic coughing or sneezing, obesity, and pregnancy.

Do inguinal hernias need treatment?

Hernias in general are not dangerous, but complications can arise the longer they are left untreated. The protruding tissue can become stuck, which can lead to pain and even tissue death if the blood supply to it is disrupted. If the herniated tissue is part of the bowels, then the patient may suffer from bowel obstruction, which is accompanied by stomach distension, vomiting, and difficulty making bowel movements.

Hernias do not heal on their own and will not minimise over time. If the hernia is thought to be minor, there may not be a need for immediate action, and a doctor may advise waiting for any progression in the condition before recommending surgery, which is the only treatment available for hernias.

What happens during hernia surgery?

In hernia surgery, the aim is to reposition the herniated tissue back where it is meant to be and to reinforce the weakness in the abdominal tissue to reduce the possibility of recurrence, which is usually achieved with a surgical mesh.

Hernia surgery can be performed openly, but innovations in surgical techniques and technology mean that most hernias are, in fact, corrected with minimally invasive methods (robotic-assisted or laparoscopic surgery). Minimally invasive hernia repair is often preferred by patients as it requires fewer incisions, resulting in smaller and less visible scars, shorter recovery period, and lower risk of post-procedure complications like infection. However, open surgery may be required for patients with complex hernias and health concerns.

The recovery period for hernia surgery is around a month, and patients can gradually restart their normal activities, provided they do not put too much pressure on the abdomen as that can lead to recurrence of the inguinal hernia.