Treatment of inguinal hernia

An inguinal hernia is a fairly common disease that causes a lot of inconvenience to its owner. Hernia is characterized by pain, discomfort when walking, and dysfunction of internal organs. Treatment of an inguinal hernia is the only way to get rid of the disease forever.

Treatment methods for inguinal hernia

What are the methods of treating an inguinal hernia? In fact, a hernia can be cured radically only in one way - surgically.

In modern medicine, inguinal hernia treatment is most often performed as an operation using a mesh - mandatory, when the patient reaches 16 years of age. Surgery without installing a mesh often leads to a relapse of the disease, when the hernia appears again and in the same area. Such relapses occur in 40% of cases of operations without a mesh.

The mesh material is polypropylene, which does not cause rejection in the body. For inguinal hernia, the polypropylene used is light, elastic and composite, not causing the formation of rough scars.

In addition to surgery, other methods of therapy are known (we will consider them further). However, all of them have only a temporary effect. The disease can be completely cured only by surgery.

The principles of treating inguinal hernias consist of removing and suturing the hernial sac, with the reduction of the prolapsed organs back into the abdominal cavity and the restoration of the full anatomy of the inguinal region. Given the close adjacency of the hernial sac and the vas deferens, the surgical intervention must be delicate and highly technical.

Conservative methods cannot in any way influence the healing of the anterior abdominal wall defect. The purpose of such methods can only be to temporarily alleviate the patient's condition.

Methods of inguinal hernia repair

Currently, two main methods of surgical intervention for inguinal hernias have been developed: the tension and non-tension methods.

• Tension plastic method.

For many years, leading surgical specialists have been pondering the most effective method of eliminating abdominal wall defects by tightening and suturing the patient's own tissue. Such operations can proceed in different ways, so they are divided into two main categories:

• plastic tension of the anterior wall of the inguinal canal;
• plastic tension of the back wall.

The second type of surgery is considered the most common. However, the main disadvantage of plastic tension is frequent relapses - up to 20% of cases of repeated development of the disease, as well as the presence of postoperative pain, long-term disability and recovery.

• Non-tension plastic surgery method.

The tension-free technique is used much more often than the tension technique today. This type of surgery uses specific synthetic polymeric materials of a mesh structure - these are absolutely harmless implants that perfectly take root inside the body and are not rejected by tissues. The meshes are placed deep into the tissues of the inguinal canal, preventing contact with the spermatic cord and reducing the likelihood of pain and relapses.

Surgical treatment of inguinal hernia

Currently, three of the most effective methods of surgical intervention for inguinal hernias are used in world medicine:

• The Lichtenstein operation is performed under local anesthesia - the patient is conscious. The doctor makes an incision in the groin (approximately 7 cm), separates the spermatic cord (or the round ligament of the uterus), cuts off the hernia or reduces it. The abdominal wall defect is sutured, and a special fixing mesh with an opening for the spermatic cord is placed and sewn between the muscle layers. The damaged tissues are sutured. A specific suture material is used for the operation, which is self-absorbing and not rejected by the body.

The operation can be performed on an outpatient basis, and the patient can go home within 3 hours after the procedure. External stitches are removed after a week.

Local anesthesia during surgery is performed with drugs such as Marcain or Naropin.

• Laparoscopic treatment of inguinal hernias involves the use of an endoscope. Three punctures are made in the anterior abdominal wall, through which gas is pumped into the abdominal cavity and special instruments and an endoscope are inserted. A mesh is inserted into the cavity and fixed in the right place. The defects are sutured.

The operation uses general anesthesia, so it is not recommended for patients with heart or respiratory diseases.

Laparoscopic surgery is minimally invasive and has a minimum number of complications (side effects include weakness, dyspeptic disorders, pain in the intercostal muscles, thrombosis). The rehabilitation period after laparoscopy is minimal.

• The third method used is also endoscopic, however, the intervention is carried out through the preperitoneal space. Anesthesia is mainly epidural, peridural or general. The essence of the operation is the creation of an artificial space in the gap between the muscle layers and the abdominal wall on the side of the hernial protrusion. Through this space, instruments are inserted into the cavity, which separate the hernia and spermatic cord. A mesh is installed in the intermuscular and interperitoneal area, which is fixed independently by holding it with intraperitoneal pressure: special suturing of the mesh is not required. Thanks to this, the risk of postoperative pain is significantly reduced, and the patient can return to his normal rhythm of life in a week. This surgical intervention is more expensive, but has a minimal recovery period.

Laser treatment of inguinal hernia (one of the most modern surgical methods) is extremely rare – this method is used mainly to treat tumors and hernias of the spine. The use of a laser for inguinal hernia is often inappropriate.

Treatment of strangulated inguinal hernia

When a hernia is strangulated, an urgent herniotomy operation is performed, the purpose of which is no longer plastic surgery of the inguinal canal, but the elimination of the strangulation itself and its possible complications.

• If the intestinal section that ended up in the hernial sac has not succumbed to necrosis, the doctor will put it back in place and perform plastic surgery.
• If there are some signs of necrosis in the intestinal area, the doctor may attempt to restore the tissue with medication.
• If the intestinal loop is irreversibly necrotic, then it is excised.

Thus, when a hernia is strangulated, the patient first undergoes a diagnostic laparoscopic operation, during which the condition of the strangulated areas is assessed. If the strangulated organ is recognized as viable, then the hernial orifice is sutured - the internal inguinal ring and the unhealed area of the peritoneum. If there is a suspicion that the strangulated organ is not viable, then an urgent herniolaparotomy is prescribed with possible resection of the dead area.

Endovideolaparoscopy helps to accurately examine tissue trophic disorders at the site of strangulation, and suturing during laparoscopy minimizes the possibility of injury to the testicular vessels and vas deferens.

Drug treatment of inguinal hernia

Most patients diagnosed with inguinal hernia everywhere ask doctors a painful question: “Is it possible to treat an inguinal hernia without surgery?”

The fact is that there are no medications that can eliminate hernial protrusion. It is impossible to "heal" the defect without resorting to surgical intervention. At the beginning of the disease, conservative treatment aimed at alleviating the symptoms of the hernia is allowed. However, such therapy is temporary, and sooner or later surgical intervention will still become inevitable.

Indeed, it is possible to reduce the manifestations of the disease symptoms – for example, by wearing a bandage. This will reduce the load on the groin and the pressure in the hernial sac, which will have a positive effect on the patient’s well-being. Wearing a bandage is encouraged in the early stages of the pathology and only with a reducible hernia.

In some cases, treatment of an inguinal hernia with a bandage can provoke the development of complications:

• enlargement of the bulging area due to scarring;
• pressure on the inside of the hernial sac;
• atrophic processes of facial contours;
• pressure on the spermatic cord.

Wearing a groin bandage is very common, as many patients think that this way they will be able to get rid of the problem. But this is not so: conservative treatment does not get rid of the disease, but only allows the patient to alleviate his condition and lead a normal life. Moreover, over time, if you delay the operation, the development of weakness of the groin muscles is observed, which can serve as the beginning of new diseases.

The bandage can be used for a long time only if there are compelling contraindications to surgical intervention:

• old age;
• general exhaustion (inability to tolerate surgery);
• period of bearing a child;
• acute infectious diseases;
• rehabilitation period after other operations.

Treatment of inguinal hernia at home

In everyday life, treatment of inguinal hernia can eliminate unpleasant symptoms in the early stages of the disease. Doctors do not welcome such treatment, as it can waste precious time, during which the hernia will progress. Specialists are of the opinion that treatment carried out in time guarantees the possibility of a positive outcome.

Some folk healers recommend treating inguinal hernia with cold:

• wash the affected area with cold vinegar water;
• Apply ice cubes to the hernia and swallow ice cubes to relieve pain and indigestion.

However, traditional medicine doctors do not recommend this method of treatment. The fact is that the cold can provoke a spasm, which will lead to strangulation of the hernia.

Treatment of inguinal hernia with folk remedies is represented by the following recipes:

• Oak bark poultice: add 2 teaspoons of crushed bark to 400 ml of boiling water and boil for 10 minutes. Cover with a lid and leave until cool. Then filter the medicine, moisten the bandage and bandage the hernia for three hours. Repeat the procedure daily.
• A compress made from sauerkraut juice: wet gauze and apply overnight.
• Apple cider vinegar compress: make a compress using 4 tablespoons of vinegar per 400 ml of water.
• Wormwood poultice: infuse 2 tablespoons of wormwood in 400 ml of boiling water for an hour.
• Anti-hernia ointment: melt ½ kg of pork fat in a water bath and pour it into a container. Separately mix 100 ml of vinegar and one fresh egg. Mix everything, adding melted fat to 0.5 l. Place in the refrigerator for a week. After a week, add 2 quail eggs and a teaspoon of badger or nutria fat. Mix and use for bandages. The ointment can be used for a long time. Store in the refrigerator.
• Good efficiency is attributed to such a remedy: equal amounts of plantain leaves, onions and the plant golden mustache are passed through a meat grinder and mixed with pork fat. The ointment is used for bandages at night.

Herbal treatment of inguinal hernia should not be the only method of therapeutic intervention. In addition to folk remedies, it is recommended to do physical exercises, maintain immunity, eat right and prevent the development of constipation.

Treatment of inguinal hernia with physical exercises should be carried out only under the supervision of a specialist in exercise therapy. In case of the disease, exercises with a load on the abdominal muscles are not welcomed, as this may be accompanied by an increase in intra-abdominal pressure, which can significantly worsen the situation. An exception is swimming, which helps to strengthen the muscular corset.

Also undesirable are exercises using strength training equipment, including exercises in a lying position with a load on the legs.

Cardiovascular exercise is encouraged, in moderation – jogging, walking, aerobics, yoga, cycling.

Treating Inguinal Hernia with Yoga

Yoga classes should be performed three times a day: in the morning before breakfast, 2 hours after lunch and before bed. Each exercise is recommended to be repeated at least 3 times.

We lie down on our backs.

• Legs are straight, arms are stretched along the body. Slowly inhale, trying to push out the stomach as much as possible. Exhale, lowering the stomach.
• Place your legs shoulder-width apart and bend your knees, and your arms at the elbows. Inhale, and at the same time lift your pelvis, placing emphasis on the area of your shoulders, elbows, and feet.
• Place your arms along your body, feet together. Raise your straight legs to 45° one by one and together.

We sit down on a chair.

• We put our feet together. On a deep breath, we raise our right hand up, and on an exhale, we bend to the left. Then vice versa.
• We lean on the back, holding the seat with our hands. We inhale and simultaneously lift the pelvis, leaning on our hands.
• Inhale. As you exhale, alternately place your legs on your abdominal muscles.
• We reach our toes with our hands one by one, bending forward.

An inguinal hernia is not a contraindication for yoga, but not all poses are allowed: consult a specialist on this issue.

Treatment of inguinal hernia with conspiracies

Some patients sincerely believe in treating diseases with the help of spells. According to experts in this method, spells should be used closer to night, just before sunset.

Take a piece of old soap, move it around the hernia and say three times:

• The water flowed along the white banks, cut off the stones, washed away the sand. This soap fragment was given the chance to wash away, just like the hernia. As the water flows away, so does the hernia. And as the sun sets and the moon comes out, so does the illness.

Next, the following is said onto a piece of soap:

• I will wake up with the dawn, I will walk to the white water, to the seas and oceans. There the gogol splashes, having neither blueness nor redness with a tumor. There the cancer crawls, having neither blueness nor redness with a tumor. There lies the dead, having neither blueness nor redness with a tumor.

After this, you need to go to the river bank and throw a piece of soap into the water, saying:

• And Gogol, and cancer, and the body of the deceased have neither disease nor progress. And the servant of God (name) has neither a hernia nor half a hernia - there is none, and there will not be.

And one more spell against any hernia, which is read after applying a piece of water moss to the affected area:

• By the sea, by the ocean, by the island of Buyan, stone moss is laid. Under this moss the snake Skoropey gnaws, gnaws and is always full. Gnaw, snake, the hernia of the servant of God (name), and you will be full, and bow to the servant of God (name).

After completing the spell, you should return the piece of moss to the place where it was taken.

Modern methods of treatment of inguinal hernias

Surgery for inguinal hernia seems simple, but it is not: the operation is not simple. Old surgical methods, especially those performed on children and the elderly, often contributed to the development of recurrent hernias in the same place.

Currently, specialists use the latest techniques that allow for reliable correction of the patient's tissues, and the operation itself has become much less traumatic and painful. In most cases, the hernia defect is sutured using high-strength synthetic materials. In this case, surgeons may give preference to both classical intervention and laparoscopy.

Low-traumatic laparoscopy is very effective in patients with recurrent hernia, in the presence of scar tissue on the surface of the peritoneum. It is extremely undesirable to re-injure scar tissue. With the help of laparoscopy and a laparoscopic probe, the operation can be performed carefully and highly professionally.

As a rule, in modern clinics, epidural anesthesia is used for surgical interventions in adult patients, and general anesthesia is used for children.

The question of what treatment to use for an inguinal hernia is usually decided by the doctor individually. Basically, they try to prescribe the operation as soon as possible after the diagnosis is confirmed. All other methods of treatment, we repeat, have only a temporary and transient effect. Therefore, before refusing the operation, weigh all the pros and cons, consult with doctors and make a decision in favor of your future healthy and fulfilling life.