Ultrasonography of Inguinal Hernia
Open Inguinal Hernioplasty
Laparoscopic Inguinal Hernioplasty
Inguinal Hernia 腹股溝小腸氣
1.1 About inguinal hernia
Inguinal hernia, also known as groin hernia, is a type of hernia where organs from the abdominal cavity protrude through the inguinal canal and descend into the scrotum, causing swelling, discomfort, and even pain.
There are two types of inguinal hernia:
Direct inguinal hernia
Direct inguinal hernia (also known as direct inguinal hernia) refers to organs from the abdominal cavity protruding directly forward through the medial side of the inguinal triangle, without passing through the internal inguinal ring, and generally not entering the scrotum. Direct inguinal hernia is less common than indirect inguinal hernia, accounting for only 5% of inguinal hernia cases.
Indirect inguinal hernia
Indirect inguinal hernia (also known as indirect inguinal hernia) refers to organs from the abdominal cavity protruding through the internal inguinal ring, which is located on the lateral side of the inferior epigastric artery, and passing through the inguinal canal, eventually entering the scrotum. Indirect inguinal hernia accounts for 85% to 95% of all inguinal hernia cases.
1.2 Cause of inguinal hernia
Inguinal hernia can be classified into two types: congenital and acquired.
Congenital inguinal hernia
Before birth, there is a pathway between the abdominal cavity and the inguinal region in infants, commonly known as the “inguinal canal”. Normally, this pathway closes before birth. However, if it fails to close after birth and the opening of the hernia sac is small, fluid from the abdominal cavity can enter the scrotum, resulting in hydrocele. Alternatively, if the opening of the hernia sac is large, organs from the abdominal cavity (most commonly the small intestine) can protrude into the scrotum or inguinal region, causing congenital inguinal hernia.
Acquired inguinal hernia
Acquired inguinal hernia occurs later in life and is often associated with weakening of the abdominal and inguinal muscles due to aging. The small intestine protrudes through the weakened muscles and enters the inguinal canal, forming a hernia. Factors such as chronic cough, constipation, and heavy lifting can increase intra-abdominal pressure and contribute to the risk of developing acquired inguinal hernia.
1.3 Symptoms of inguinal hernia
Patients with inguinal hernia may experience swelling in the groin or even the scrotum. The swelling is usually more noticeable during walking and disappears when lying down. Patients may also experience pain, which is typically exacerbated during walking or standing.
If the hernia remains swollen, it may indicate that the tissues within the hernia sac are trapped and unable to return to the abdominal cavity, leading to an incarcerated hernia. If this condition persists, it can impede blood circulation and result in necrosis of the small intestine, known as a strangulated hernia, which can be life-threatening. If any of these symptoms occur, immediate medical attention is necessary. If a doctor confirms an incarcerated hernia, emergency surgery is required to address the condition.
1.4 Treatment of inguinal hernia
If a patient’s physical condition is not suitable for surgery, the doctor may recommend conservative treatment.
Hernia Belt (Truss)
The principle of a hernia belt (truss) is to apply pressure to the hernia to push it back into the abdominal cavity and prevent it from protruding further.
However, a hernia belt can only prevent the hernia from protruding; it does not cure the hernia condition. Once a patient stops using the hernia belt, the hernia will protrude from the abdominal cavity again. Additionally, long-term pressure from the belt can lead to local muscle atrophy in the abdominal wall, making the abdominal wall weaker and increasing the severity of the hernia. Moreover, the compression from the belt can cause friction and adhesions in the surrounding tissues, making surgery more challenging.
Therefore, doctors generally only recommend the use of a hernia belt for elderly and frail patients. If a patient’s physical condition allows, the doctor will recommend undergoing hernia repair surgery.
Surgical intervention is currently recognized as the only effective method to permanently cure a hernia. During surgery, the doctor will locate and remove the hernia sac, repair the hernia opening, and place a synthetic mesh to prevent recurrence. This is also considered the most effective surgical method in the medical field.
1.5 Operative repair of inguinal hernia
1.6 Inguinal hernia in children
Learn about Inguinal Hernia in Children and its treatment.