Nikki Sommer, a nurse with Key West Surgical Group, joined Good Morning Keys on Keys Talk 96.9/102.5FM this morning for Medical Matters.
What is an inguinal hernia?
Sommer said, “As we talked about a hernia is a part of the intestine or abdominal tissue that pushes through a weak spot in the muscle wall, causing a bulge you can feel. And in this case, it is in the groin. About 75% of abdominal hernias are inguinal hernias, much more common in men, but can happen in anyone.”
What are the symptoms of inguinal hernia?
Sommer said, “They include a groin bulge, discomfort when lifting or coughing, or a feeling of weakness, and sometimes they don’t hurt at all, like sometimes you’ll just feel a little ball in your groin like it pops out and there’s no pain or anything, but that’s a sign of an inguinal hernia. There’s a rare variant of it. It’s called the ureteral inguinal hernia, and it’s rare, but it’s just something to think about. Or if you have one and you put it off, this can occur. Sometimes your ureter, the tube that carries urine from your kidney and your bladder, can get trapped in the hernia itself, like it could get pushed through the wall, and that is called the ureteral inguinal hernia. Again, it’s rare, but it’s important, because if you don’t recognize it, you can impair your kidney function, and that could hurt your kidney, so just keep that in the back of your mind. If you have it, don’t put it off. Always have it assessed, even if it’s not bothering you. Just so you come up with a plan for if it becomes more persistent or becomes a problem.”
Most hernias won’t fix themselves, so repair is and important option.
Sommer said, “There’s what’s called an open repair, and laparoscopic repair, which we’ve talked about laparoscopic procedures before, they’re minimally invasive. It really depends on the person and the hernia. So open repair, open hernia repair, sometimes called the tension free or mesh repair, is the traditional way surgeons would fix a hernia. The surgeon makes an incision over the groin, pushes the bulging tissue back in and reinforces the weak spot with mesh or sutures. As a patient, here’s what you should know, this can be done under local anesthesia, by numbing the area. Never seen this done. Usually it’s you go to the OR for that and you get sedated, and you want to. Direct access to the hernia makes it useful for certain types of hernias or patients who can’t tolerate general anesthesia. I’ve never seen this done. I mean, I’m not saying it can’t be done. Never really seen it done. So normally they take you to surgery, and they will do the open repair. They put you under, and really, to be perfectly honest, there is a lot going on down there. Urethra is near there, so you want to be careful. You’re usually taken to the OR. Recovery is typically good. It might involve more soreness compared to the minimal invasive options. I can tell you, they do both. And again, it depends on the patient, the hernia, if it’s a reoccurring hernia, so forth, they’ll make the decision whether to do open or laparoscopic, but you still have to recover. Because it’s the same day surgery, you’re in and out, you go home. People think that the recovery in three days they’re going to be ready to jog up a flight of stairs, not going to happen. You’ve got to give yourself time to heal.”
What happens with laparoscopic hernia repair?
Sommer said it’s the “minimally invasive approach, where tiny incisions are made and a small camera and instruments are inserted to fix the hernia from the inside, so smaller incisions, often less pain afterward, potential of faster return to normal activities, yes and no, just again, everybody’s different. Some studies suggest less chronic groin pain long term compared with open surgery. That I could probably believe, because it is less invasive. Again, you’ve got muscles, tendons, you’ve got nerve endings, all the things down there when you do an open repair, and the laparoscopic repair does require general anesthesia, so it’s not right for everyone. There are two different types of laparoscopic techniques. That is something that the surgeon will decide which technique they use. They will just describe the procedure itself.”
Recovery instructions should be taken seriously.
Sommer said, “You’ll get instructions. You’re not going to be able to lift or do anything heavy for four to six weeks with either repair. And it could be longer, depending on some people have recurring hernias, and it’s because it’s the mechanical movement of the body that you’re doing that caused the hernia in the first place. So if it’s a work related thing, like, if you do a lot of heavy lifting, a lot of bending, lifting stuff over your head, you have weak abdominal wall muscles, you’re at risk for hernia, and if you don’t heal right the first time, it can happen again. So you need to really look at your activity, what caused the hernia in the first place, and then post surgery, you need to modify that activity or behavior if you think it’s going to aggravate it again. You will get instructions on pain management and activity levels. So you’re usually sent home with some pain medicine for a couple of days. Usually after the second or third day, you don’t need it. Expect a lot of swelling. So in the inguinal area, gravity, especially men, there’s a lot of scrotal swelling, and they get freaked out, but it goes away. It’s just common. It’s common. Post surgery in anything you can get a pocket of accumulated serous fluid, they call it. So sometimes you may feel like you have a bulge. I’ve gotten phone calls where they’ll be like the bulge is back. It’s not. It’s actually like a pocket of fluid, and your body usually reabsorbs that all on its own.”
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