Ultrasonography of Inguinal Hernia
Open Inguinal Hernioplasty
Laparoscopic Inguinal Hernioplasty
Femoral Hernia 股小腸氣
1.1 About femoral hernia
Femoral hernia is a type of hernia involving the protrusion of abdominal organs through the femoral ring and into the femoral canal. Femoral hernia (femoral herniation) is most commonly seen in middle-aged and elderly women.
1.2 Cause of femoral hernia
The femoral canal is located on the inner side of the thigh and is a narrow, funnel-shaped aperture containing fat, loose connective tissue, and lymph nodes. The opening above the femoral canal is called the femoral ring.
In middle-aged and elderly women, particularly those who are thin and frail, the femoral canal tends to be wider and contains less fatty tissue. As a result, abdominal organs or tissues are more prone to protrude through the femoral ring and femoral canal, leading to femoral hernia.
1.3 Symptoms of femoral hernia
Patients with femoral hernia may experience swelling on the upper inner side of the thigh. Unlike inguinal hernia, the swelling often does not naturally reduce when the patient lies flat. This is because the femoral canal is typically very narrow, making it easier for the herniated small intestine to become trapped within the femoral canal.
The swelling may cause discomfort or pain. If the pain persists and becomes severe, it may indicate that the organs (such as the small intestine) within the hernia sac are being compromised due to constriction at the hernia opening, leading to a strangulated hernia. In such cases, emergency surgery is necessary. If any of these symptoms are present, immediate medical attention should be sought. If a doctor confirms the presence of a strangulated femoral hernia, prompt surgical intervention is required.
1.4 Treatment of femoral hernia
Surgical intervention is currently recognized as the only effective treatment for femoral hernia. During the surgery, the doctor will locate and remove the hernia sac, repair the defect in the femoral canal, and place a synthetic mesh to prevent recurrence. This is currently considered the most effective surgical method in the medical field.
Doctors recommend that all patients with femoral hernia undergo surgical treatment if their physical condition permits, to prevent the occurrence of emergency complications.
Conventional (open ) femoral hernioplasty
- Depending on the patient’s physical condition, the surgery can be performed under general anesthesia, spinal anesthesia, or local anesthesia.
- Depending on the location of the surgical incision and the site of repair, the surgery can be classified into high-level and low-level repair procedures. In simple terms, the surgeon will locate and remove the hernia sac, repair the defect in the femoral canal, and place a synthetic mesh in the abdominal wall or femoral canal to prevent recurrence. After the surgeon controls the bleeding, the incision will be sutured with absorbable stitches and covered with waterproof dressings. The surgery usually takes about 1 hour.
Laparoscopic femoral hernioplasty
- The surgery is performed under general anesthesia. The surgeon will make a small incision of about one centimeter below the patient’s umbilicus and then perform laparoscopic surgery. Laparoscope is a surgical instrument with a high-definition camera at the front, which transmits images of the surgical area to a monitor, allowing the surgeon to observe the surgical area and perform the operation accordingly.
- The surgeon will make two 5mm incisions in the abdominal wall to insert laparoscopic instruments for the surgery. The laparoscopic instruments replace the surgeon’s hands, allowing the incisions to be significantly smaller. The surgeon will use the laparoscopic instruments to locate and remove the hernia sac, repair the femoral hernia defect in the abdominal wall, and place a synthetic mesh to cover the defect, preventing hernia recurrence. After controlling the bleeding, the incisions will be sutured with absorbable stitches and covered with waterproof dressings.
- This minimally invasive repair surgery is a relatively newer approach that significantly reduces postoperative pain for the patient and effectively prevents hernia recurrence. The surgery usually takes about one to two hours.
- The advantages of this surgery are smaller incisions, significantly reduced postoperative pain for the patient, and shorter recovery time.