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Inguinal Herniorrhaphy

Group 7

Submitted to :

Mrs. Therisita Cruz

Submitted by :

Atienza,Ma. Ana

Bantuas,Sahara L.

Bernardo,Sittie Areej
Introduction

Inguinal herniorrhaphy is a common day care surgical procedure and can be performed
safely under regional or general anaesthesia. 1 Since inguinal hernia is rarely associated with
serious complications, it is an ideal surgical procedure for ambulatory settings. Outpatient
inguinal herniorrhaphy has been associated with remarkable reductions in cost without any
obvious increase in complication rates or recurrence of hernia. An ideal outpatient anaesthetic
technique would provide for excellent operating conditions, a rapid recovery, no postoperative
side effects and high patient satisfaction. In addition to increasing the quality and improving the
operating room efficiency, the ideal anaesthetic technique would also decrease the costs of the
anaesthetic services in the form of rapid turnover of the patients and provide for an early
discharge.

About 75% of all hernias are classified as inguinal hernias, which are the most common
type of hernia occurring in men and women as a result of the activities of normal living and
aging. Because humans stand upright, there is a greater downward force on the lower abdomen,
increasing pressure on the less muscled and naturally weaker tissues of the groin area. Inguinal
hernias do not include those caused by a cut (incision) in the abdominal wall (incisional hernia).
According to the National Center for Health Statistics, about 700,000 inguinal hernias are
repaired annually in the United States. The inguinal hernia is usually seen or felt first as a tender
and sometimes painful lump in the upper groin where the inguinal canal passes through the
abdominal wall. The inguinal canal is the normal route by which testes descend into the scrotum
in the male fetus, which is one reason these hernias occur more frequently in men.

Herniorrhaphy (Hernioplasty, Hernia repair) is a surgical procedure for correcting hernia.


A hernia is a bulging of internal organs or tissues, which protrude through an abnormal opening
in the muscle wall. Hernias can occur in the abdomen, groin, and at the site of a previous
surgery.

An operation in which the hernia sac is removed without any repair of the inguinal canal
is described as a 'herniotomy'. When herniotomy is combined with a reinforced repair of the
posterior inguinal canal wall with autogenous (patient's own tissue) or heterogeneous (like steel
or prolene mesh) material it is termed Hernioplasty as opposed to herniorrhaphy in which no
autogenous or heterogeneous material is used for reinforcement.

We therefore, conducted this case analysis study for daycare inguinal hernia repair, with
respect to preparation and discharge times as well as cost effectiveness in patients’
Inguinal hernia
(pronounced /ˈɪŋɡwɨnəl ˈhɜrniə/) is a protrusion of abdominal-cavity contents through
the inguinal canal. They are very common (lifetime risk 27% for men, 3% for women[1]), and
their repair is one of the most frequently performed surgical operations.

Inguinal hernia repair, also known as herniorrhaphy, is the surgical correction of an


inguinal hernia. An inguinal hernia is an opening, weakness, or bulge in the lining tissue
(peritoneum) of the abdominal wall in the groin area between the abdomen and the thigh. The
surgery may be a standard open procedure through an incision large enough to access the hernia
or a laparoscopic procedure performed through tiny incisions, using an instrument with a camera
attached (laparoscope) and a video monitor to guide the repair. When the surgery involves
reinforcing the weakened area with steel mesh, the repair is called hernioplasty.
There are two types of inguinal hernia, direct and indirect, which are defined by their
relationship to the inferior epigastric vessels. Direct inguinal hernias occur medial to the inferior
epigastric vessels when abdominal contents herniate through the superficial inguinal ring.
Indirect inguinal hernias occur when abdominal contents protrude through the deep inguinal ring,
lateral to the inferior epigastric vessels; this may be caused by failure of embryonic closure of
the processus vaginalis.
In the case of the female, the opening of the superficial inguinal ring is smaller than that
of the male. As a result, the possibility for hernias through the inguinal canal in males is much
greater because they have a larger opening and therefore a much weaker wall for the intestines to
protrude through.

Covered
Relationship to
by internal Usual
Type Description inferior
spermatic onset
epigastric vessels
fascia?

protrudes through the inguinal ring and


indirect is ultimately the result of the failure of
inguinal embryonic closure of the internal Lateral Yes Congenital
hernia inguinal ring after the testicle passes
through it

enters through a weak point in the


direct fascia of the abdominal wall
inguinal (Hesselbach triangle)less common Medial No Adult
hernia 25%-30% of inguinal hernia . most
occur in men at 40 years and above .
Purpose
Inguinal hernia repair is performed to close or mend the weakened abdominal wall of an
inquinal hernia.

Demographics
The majority of hernias occur in males. Nearly 25% of men and only 2% of women in the
United States will develop inguinal hernias. Inguinal hernias occur nearly three times more often
in African American adults than in Caucasians. Among children, the risk of groin hernia is
greater in premature infants or those of low birth weight. Indirect inguinal hernias will occur in
10–20 children in every 1,000 live births.

Description
About 75% of all hernias are classified as inguinal hernias, which are the most common
type of hernia occurring in men and women as a result of the activities of normal living and
aging. Because humans stand upright, there is a greater downward force on the lower abdomen,
increasing pressure on the less muscled and naturally weaker tissues of the groin area. Inguinal
hernias do not include those caused by a cut (incision) in the abdominal wall (incisional hernia).
According to the National Center for Health Statistics, about 700,000 inguinal hernias are
repaired annually in the United States. The inguinal hernia is usually seen or felt first as a tender
and sometimes painful lump in the upper groin where the inguinal canal passes through the
abdominal wall. The inguinal canal is the normal route by which testes descend into the scrotum
in the male fetus, which is one reason these hernias occur more frequently in men.
Hernias are divided into two categories: congenital (from birth), also called indirect
hernias, and acquired, also called direct hernias. Among the 75% of hernias classified as inguinal
hernias, 50% are indirect or congenital hernias, occurring when the inguinal canal entrance fails
to close normally before birth. The indirect inguinal hernia pushes down from the abdomen and
through the inguinal canal. This condition is found in 2% of all adult males and in 1–2% of male
children. Indirect inguinal hernias can occur in women, too, when abdominal pressure pushes
folds of genital tissue into the inquinal canal opening. In fact, women will more likely have an
indirect inguinal hernia than direct. Direct or acquired inguinal hernias occur when part of the
large intestine protrudes through a weakened area of muscles in the groin. The weakening results
from a variety of factors encountered in the wear and tear of life.

Inguinal hernias may occur on one side of the groin or both sides at the same or different
times, but occur most often on the right side. About 60% of hernias found in children, for
example, will be on the right side, about 30% on the left, and 10% on both sides. The muscular
weak spots develop because of pressure on the abdominal muscles in the groin area occurring
during normal activities such as lifting, coughing, straining during urination or bowel
movements, pregnancy, or excessive weight gain. Internal organs such as the intestines may then
push through this weak spot, causing a bulge of tissue. A congenital indirect inguinal hernia may
be diagnosed in infancy, childhood, or later in adulthood, influenced by the same causes as direct
hernia. There is evidence that a tendency for inguinal hernia may be inherited.

A direct and an indirect inguinal hernia may occur at the same time; this combined hernia
is called a pantaloon hernia.

A femoral hernia is another type of hernia that appears in the groin, occurring when
abdominal organs and tissue press through the femoral ring (passageway where the major
femoral artery and vein extend from the leg into the abdomen) into the upper thigh. About 3% of
all hernias are femoral, and 84% of all femoral hernias occur in women. These are not inquinal
hernias, but they can sometimes confusethe diagnosis of inguinal hernias because they curve
over the inguinal area. They are more often accompanied by intestinal obstruction than inguinal
hernias.
Because inguinal hernias do not heal on their own and can become larger or twisted,
which may close off the intestines, the prevailing medical opinion is that hernias must be treated
surgically when they cause pain or limit activity. Protruding intestines can sometimes be pushed
back temporarily into the abdominal cavity, or an external support (truss) may be worn to hold
the area in place until surgery can be performed. Sometimes, other medical conditions
complicate the presence of a hernia by adding constant abdominal pressure. These conditions,
including chronic coughing, constipation, fluid retention, or urinary obstruction, must be treated
simultaneously to reduce abdominal pressure and the recurrence of hernias after repair. A
relationship between smoking and hernia development has also been shown. Groin hernias occur
more frequently in smokers than nonsmokers, especially in women. A hernia may become
incarcerated, which means that it is trapped in place and cannot slip back into the abdomen. This
causes bowel obstruction, which may require the removal of affected parts of the intestines
(bowel resection) as well as hernia repair. If the herniated intestine becomes twisted, blood
supply to the intestines may be cut off (intestinal ischemia) and the hernia is said to be
strangulated, a condition causing severe pain and requiring immediate surgery.

Anatomy
Pathophysiology
Indirect inguinal hernias usually occur because of a persistent process vaginalis. As the
hernia emerges through the deep internal ring, it carries with it fascial linings of the tissue it
transverses. The hernia courses along the inguinal canal lateral to the epigastric arteries and
emerges through the external ring slightly lateral to the pubic tubercle. Contents of this hernia
then follow the tract of the spermatic cord down into the scrotal sac in men, or follows the round
ligament in females.

Direct hernias are always acquired and therefore unusual in the young. They typically
affect middle-aged or elderly patients. A direct inguinal hernia occurs because of degeneration
and fatty changes in the aponeurosis of the transversalis fascia in the Hesselbach triangle area.
The Hesselbach triangle is defined inferiorly by the inguinal ligament, laterally by the inferior
epigastric arteries and medially by the lateral border of rectus abdominus.

Because of the wide neck of a direct hernia, it rarely strangulates. Strangulation is more
common with indirect hernia, which has a narrow neck. As segments of the intestine prolapse
through the defect in the anterior abdominal wall, they cause sequestration of fluid within the
lumen of the herniated bowel.

This initially impairs the lymphatic and venous drainage, which further compounds the
swelling, and over time the arterial supply becomes involved. The increased intraluminal
pressure causes the wall of the affected segment to become congested, which leads to
extravasations of blood into the hernia sac.

The normal pinkish and shining color of the bowel wall is lost and replaced with a dull
congested bowel segment, followed by loss of tone within the bowel wall. This favors bacterial
proliferation and subsequent infection of the blood-stained fluid in the hernia sac. Gangrene
ensues and, if left untreated, perforation occurs. Peritonitis occurs initially within the sac and
then spreads to the peritoneal cavity.
Surgical
(Direct Inguinal Hernia)
(Indirect inguinal hernia)

After Surgical procedures


Surgical incision in groin after inguinal hernia operation.

Surgical correction of inguinal hernias, called a herniorrhaphy or hernioplasty, is now


often performed as outpatient surgery. There are various surgical strategies which may be
considered in the planning of inguinal hernia repair. These include the consideration of mesh use,
type of open repair, use oflaparoscopy, type of anesthesia, appropriateness of bilateral repair, etc.
During surgery conducted under local anaesthesia, the patient will be asked to cough and strain
during the procedure to help in demonstrating that the repair is "tension free" and sound

In open inguinal hernia repair procedures, the patient is typically given a light general
anesthesia of short duration. Local or regional anesthetics may be given to some patients. Open
surgical repair of an indirect hernia begins with sterilizing and draping the inguinal area of the
abdomen just above the thigh. An incision is made in the abdominal wall and fatty tissue
removed to expose the inguinal canal and define the outer margins of the hole or weakness in the
muscle. The weakened section of tissue is dissected (cut and removed) and the inguinal canal
opening is sutured closed (primary closure), making sure that no abdominal organ tissue is
within the sutured area. The exposed inguinal canal is examined for any other trouble spots that
may need reinforcement. Closing the underlayers of tissue (subcutaneous tissue) with fine
sutures and the outer skin with staples completes the procedure. A sterile dressing is then
applied.

An open repair of a direct hernia begins just as the repair of an indirect hernia, with an incision
made in the same location above the thigh, just large enough to allow visualization of the hernia.
The surgeon will look for and palpate (touch) the bulging area of the hernia and will reduce it by
placing sutures in the fat layer of the abdominal wall. The hernial sac itself will be closed, as in
the repair of the indirect hernia, by using a series of sutures from one end of the weakened hernia
defect to the other. The repair will be checked for sturdiness and for any tension on the new
sutures. The subcutaneous tissue and skin will be closed and a sterile dressing applied.

Laparoscopic procedures
are conducted using general anesthesia. The surgeon will make three tiny incisions in the
abdominal wall of the groin area and inflate the abdomen with carbon dioxide to expand the
surgical area. A laparoscope, which is a tube-like fiber-optic instrument with a small video
camera attached to its tip, will be inserted in one incision and surgical instruments inserted in the
other incisions. The surgeon will view the movement of the instruments on a video monitor, as
the hernia is pushed back into place and the hernial sac is repaired with surgical sutures or
staples. Laparoscopic surgery is believed to produce less postoperative pain and a
quicker recovery time. The risk of infection is also reduced because of the small incisions
required in laparoscopic surgery.

The use of surgical (prosthetic) steel mesh or polypropylene mesh in the repair of inguinal
hernias has been shown to help prevent recurrent hernias. Instead of the tension that develops
between sutures and the skin in a conventionally repaired area, hernioplasty using mesh patches
has been shown to virtually eliminate tension. The procedure is often performed in an outpatient
facility withlocal anesthesia and patients can walk away the same day, with little restrictions in
activity. Tension-free repair is also quick and easy to perform using the laparoscopic method,
although general anesthesia is usually used. In either open or laparoscopic procedures, the mesh
is placed so that it overlaps the healthy skin around the hernia opening and then is sutured into
place with fine silk. Rather than pulling the hole closed as in conventional repair, the mesh
makes a bridge over the hole and as normal healing take place, the mesh is incorporated into
normal tissue without resulting tension.

Diagnosis
Reviewing the patient's symptoms and medical history are the first steps in diagnosing a
hernia. The surgeon will ask when the patient first noticed a lump or bulge in the groin area,
whether or not it has grown larger, and how much pain the patient is experiencing. The doctor
will palpate the area, looking for any abnormal bulging or mass, and may ask the patient to
cough or strain in order to see and feel the hernia more easily. This may be all that is needed to
diagnose an inguinal hernia. To confirm the presence of the hernia, an
ultrasound examination may be performed. The ultrasound scan will allow the doctor to visualize
the hernia and to make sure that the bulge is not another type of abdominal mass such as
a tumoror enlarged lymph gland. It is not usually possible to determine whether the hernia is
direct or indirect until surgery is performed.

Signs and symptoms


Frontal view of an inguinal hernia (area shaved prior to hospitalisation and surgical repair
procedure).

Hernias present as bulges in the groin area that can become more prominent when
coughing, straining, or standing up. They are rarely painful, and the bulge commonly disappears
on lying down. The inability to "reduce", or place the bulge back into the abdomen usually
means the hernia is 'incarcerated' which requires surgery to correct.
Significant pain is suggestive of strangulated bowel (an incarcerated indirect inguinal hernia).
As the hernia progresses, contents of the abdominal cavity, such as the intestines, can descend
into the hernia and run the risk of being pinched within the hernia, causing an intestinal
obstruction. If the blood supply of the portion of the intestine caught in the hernia is
compromised, the hernia is deemed "strangulated," and gut ischemia and gangrene can result,
with potentially fatal consequences. The timing of complications is not predictable. Some hernias
remain static for years, others progress rapidly from the time of onset. Provided there are no
serious co-existing medical problems, patients are advised to get the hernia repaired surgically at
the earliest convenience after a diagnosis is made. Emergency surgery for complications such as
incarceration and strangulation carry much higher risk than planned, "elective" procedures.
Differential diagnosis of the symptoms of inguinal hernia mainly includes the following potential
conditions:[2]

 Femoral hernia
 Epididymitis
 Testicular torsion
 Lipomas
 Inguinal adenopathy (Lymph node Swelling)
 Groin abscess
 Saphenous vein dilation, called Saphena varix
 Vascular aneurysm or pseudoaneurysm
 Hydrocele
 Varicocele
 Cryptorchidism (Undescended testes)

Causes:

The weakness in the abdominal wall can be congenital injures and certain abdominal operation
may increase hernia.

Other Factors:

-Chronic constipation leading during bowel movements of urination.

-Heavy lifting.

-Excess weight.

-pregnancy chronic

-coughing chronic,sneezing

-family history of hernias and premature birth.

Preparation

Patients will have standard preoperative blood and urine tests, anelectrocardiogram, and
a chest x ray to make sure that the heart, lungs, and major organ systems are functioning well. A
week or so before surgery, medications may be discontinued,
especially aspirin or anticoagulant (blood-thinning) drugs. Starting the night before surgery,
patients must not eat or drink anything. Once in the hospital, a tube may be placed into a vein in
the arm (intravenous line) to deliver fluid and medication during surgery. A sedative may be
given to relax the patient.

Management
Medical
The hernia truss is intended to contain a reducible inguinal hernia within the abdomen.
This device fell out of favour with the advent of hernia surgery. It is not considered to provide a
cure, and if the pads are hard and intrude into the hernia aperture they may cause scarring and
enlargement of the aperture. In addition, most trusses with older designs are not able effectively
to contain the hernia at all times, because their pads do not remain permanently in contact with
the hernia. The more modern variety of truss (medicine) is made with non-intrusive flat pads and
comes with a guarantee to hold the hernia securely during all activities. Although there is as yet
no proof that such devices can prevent an inguinal hernia from progressing, they have been
described by users as providing greater confidence and comfort when carrying out physically
demanding tasksTheir popularity is likely to increase, as many individuals with small, painless
hernias are now delaying hernia surgery due to recently published reports on the incidence of
Post Herniorrhaphy Pain Syndrome.

Surgical
Herniorrhaphy

What to Expect After Surgery

For adults, open surgery for hernia repair usually involves a recovery period of up to 4
weeks before resuming normal strenuous activities. But this varies depending on the individual.

Aftercare
The hernia repair site must be kept clean and any sign of swelling or redness reported to
the surgeon. Patients should also report a fever, and men should report any pain or swelling of
the testicles. The surgeon may remove the outer sutures in a follow-up visit about a week after
surgery. Activities may be limited to non-strenuous movement for up to two weeks, depending
on the type of surgery performed and whether or not the surgery is the first hernia repair. To
allow proper healing of muscle tissue, hernia repair patients should avoid heavy lifting for six to
eight weeks after surgery. The postoperative activities of patients undergoing repeat procedures
may be even more restricted.

Inguinal Hernia Repair - Series: Aftercare


Prevention

You can't prevent the congenital defect that may lead to an inguinal hernia, but the following
steps can help reduce strain on your abdominal muscles and tissues:

• Maintain a healthy weight. If you think you may be overweight, talk to your doctor
about the best exercise and diet plan for you.
• Emphasize high-fiber foods. Fresh fruits and veget ables and whole grains are good for
your overall health. They're also packed with fiber that can help prevent constipation and
straining.
• Lift heavy objects carefully or avoid heavy lifting altogether. If you have to lift
something heavy, always bend from your knees, not from your waist.
• Stop smoking. In addition to increasing your risk of serious diseases such as cancer,
emphysema and heart disease, smoking often causes a chronic cough that can lead to or
aggravate an inguinal hernia.
• Don't rely on a truss for support. Contrary to what you may have heard, wearing a truss
isn't the best long-term solution for an inguinal hernia. A truss won't protect against
complications or correct the underlying problem, although your doctor may recommend
wearing one for a short time before surgery.
Risks
Hernia surgery is considered to be a relatively safe procedure, although complication
rates range from 1–26%, most in the 7–12% range. This means that about 10% of the
700,000 inguinal hernia repairs each year will have complications. Certain specialized clinics
report markedly fewer complications, often related to whether open or laparoscopic technique is
used. One of the greatest risks of inquinalhernia repair is that the hernia will recur.
Unfortunately, 10–15% of hernias may develop again at the same site in adults, representing
about 100,000 recurrences annually. The risk of recurrence in children is only about 1%.
Recurrent hernias can present a serious problem because incarceration and strangulation are
more likely and because additional surgical repair is more difficult than the first surgery. When
the first hernia repair breaks down, the surgeon must work around scar tissue as well as the
recurrent hernia. Incisional hernias, which are hernias that occur at the site of a prior surgery,
present the same circumstance of combined scar tissue and hernia and even greater risk of
recurrence. Each time a repair is performed, the surgery is less likely to be successful.
Recurrence and infection rates for mesh repairs have been shown in some studies to be lower
than with conventional surgeries.

Complications that can occur during surgery include injury to the spermatic cord structure;
injuries to veins or arteries, causing hemorrhage; severing or entrapping nerves, which can cause
paralysis; injuries to the bladder or bowel; reactions toanesthesia; and systemic complications
such as cardiac arrythmias, cardiac arrest, or death. Postoperative complications include infection
of the surgical incision (less in laparoscopy); the formation of blood clots at the site that can
travel to other parts of the body; pulmonary (lung) problems; and urinary retention or urinary
tract infection.

Healthy children who have a hernia repair have few risks. The surgery usually is done on an
outpatient basis.

• The surgeon may check to see whether a child younger than 1 year also has a hernia on
the other side of the groin. If there is one, it may be repaired during the same surgery to
avoid the risks of a second surgery. In males, this practice involves putting both testicles
at risk at the same time.
• Males with hydrocele and hernia may have both problems repaired at the same time to
avoid the risks of a second surgery.
• Premature babies are at risk for heart and lung complications during surgery.

Adults and children who have a hernia repair are at risk for:

• Reaction to anesthesia (main risk).


• Infection and bleeding at the site.
• Nerve damage, numbness of skin, loss of blood supply to scrotum or testicles resulting in
testicular atrophy (all infrequent).
• Damage to the cord that carries sperm from the testicles to the penis (vas deferens), resulting
in an inability to father children.
• Damage to the femoral artery or vein.

What To Think About

The following people need special preparation before surgery to reduce the risk of
complications:

• Those with a history of blood clots in large blood vessels (deep vein thrombosis)
• Smokers
• Those taking large doses of aspirin
• Those taking anticoagulation medicines (such as warfarin or heparin)

Most inguinal hernia repair surgery on adults of all ages and healthy children is done on an
outpatient basis. This lowers costs (as much as 50% lower than inpatient surgery, which requires
a stay in the hospital) and may reduce infection. Outpatient surgery takes about 1 hour.
Inpatient surgery is sometimes recommended for people who have:

• Unusual, recurrent hernias.


• Very large hernias.
• Hernias on both sides (bilateral hernias).
• Severe illnesses (such as heart or lung disease), or who are taking anticoagulant
medicines.

Infants with the following conditions may need to be hospitalized for hernia surgery:

• Lung problems, such as bronchopulmonary dysplasia

Normal results
Inguinal hernia repair is usually effective, depending on the size of the hernia, how much
time has gone by between its first appearance and the corrective surgery, and the underlying
condition of the patient. Most first-time hernia repair procedures will be one-day surgeries, in
which the patient will go home the same day or in 24 hours. Only the most challenging cases will
require an overnight stay. Recovery times will vary, depending on the type of surgery performed.
Patients undergoing open surgery will experience little discomfort and will resume normal
activities within one to two weeks. Laparoscopy patients will be able to enjoy normal activities
within one or two days, returning to a normal work routine and lifestyle within four to seven
days, with the exception of heavy lifting and contact sports.

How Well It Works

Open surgery for inguinal hernia repair is safe. The recurrence rate (hernias that require
two or more repairs) is low when open hernia repair is done by experienced surgeons using mesh
patches. Synthetic patches are now widely used for hernia repair in both open and laparoscopic
surgery.

The chance of a hernia coming back after open surgery ranges from 1 to 10 out of every 100
open surgeries done.

Morbidity and mortality rates


Mortality related to inguinal hernia repair or postoperative complications is unlikely, but
with advanced age or severe underlying conditions, deaths do occur. Recurrence is a notable
complication and is associated with increased morbidity, with recurrence rates for indirect
hernias from less than 1–7% and 4–10% for direct.

Alternatives
If a hernia is not surgically repaired, an incarcerated or strangulated hernia can result,
sometimes involving life-threatening bowel obstruction or ischemia.

Points to Remember
• An inguinal hernia is a condition in which intra-abdominal fat or part of the small
intestine, also called the small bowel, bulges through a weak area in the lower
abdominal muscles. An inguinal hernia occurs in the groin—the area between the
abdomen and thigh.

• An inguinal hernia can occur any time from infancy to adulthood and is much
more common in males than females.

• Direct and indirect hernias are the two types of inguinal hernia, and they have
different causes.

• Symptoms of an inguinal hernia usually appear gradually and include a bulge in


the groin, discomfort or sharp pain, a feeling of weakness or pressure in the
groin, and a burning, gurgling, or aching feeling at the bulge.

• An incarcerated inguinal hernia is a hernia that becomes stuck in the groin or


scrotum and cannot be massaged back into the abdomen.

• A strangulated hernia, in which the blood supply to the incarcerated small


intestine is jeopardized, is a serious condition and requires immediate medical
attention. Symptoms include extreme tenderness and redness in the area of the
bulge, sudden pain that worsens quickly, fever, rapid heart rate, nausea, and
vomiting.

• An inguinal hernia is diagnosed through a physical examination.

• Inguinal hernias may be repaired through surgery. Surgery is performed through


one incision or with a laparoscope and several small incisions.

Surgery for inguinal hernia is usually done 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.