Adult inguinal hernia treatment

  Inguinal hernia is the presence of a hernia sac structure protruding towards the body surface in the inguinal region, where intra-abdominal organs or tissues can enter the sac through a congenital or acquired formed abdominal wall defect (a mass is found in the inguinal region, which is dislodged after an increase in abdominal pressure such as standing or coughing and can disappear after lying down). Common causes of inguinal hernia formation are: increased intra-abdominal pressure, weakness of the abdominal wall such as atrophy of the abdominal wall muscles in the elderly, long-term smoking, obesity, low incision in the lower abdomen, etc.  Diagnosis: A typical inguinal hernia can be diagnosed on the basis of medical history (a reversible mass is found in the inguinal region, i.e. the mass comes out after an increase in abdominal pressure such as standing or coughing, and disappears after lying down) and physical examination.  Treatment: Since adult hernia is not self-healing, surgery is still the only curative method available.  Elective surgery is recommended for asymptomatic inguinal hernias and for symptomatic inguinal hernias. (Consider the possibility of inguinal hernia complicated by intussusception and necrosis). Emergency surgery should be performed for incarcerated and strangulated hernias, especially for female patients with incarcerated hernias (female patients tend to have femoral hernias, which are highly susceptible to small bowel necrosis).  Tension-free hernia repair is currently the main surgical treatment. Tension-free repair can reduce postoperative pain, shorten recovery time, and decrease the recurrence rate of hernias. It is still controversial whether to use patch for emergency surgery of incarcerated hernia. I believe that tension-free repair is recommended for patients without intestinal necrosis and hemorrhagic ascites. The surgical treatment of recurrent hernias is mostly posterior entry or laparoscopic surgical repair.  Complications: hematoma and seroma at the surgical site, scrotal hematoma, scrotal effusion, incisional infection injury, etc. Recurrence (recurrence is still possible with the various surgical methods currently available to treat inguinal hernias, with an overall surgical recurrence rate of no more than 1%.) .  Length of hospitalization: Since our hospital currently uses absorbable sutures for intradermal suturing, there is no need to remove sutures after surgery and the patient can be discharged 3-5 days after surgery.