Recognizing inguinal hernia

  The term “hernia” mainly refers to inguinal hernia, which is a common and frequent disease. It manifests as a mass protruding from the inguinal region, which is obvious when standing and walking or coughing, and can disappear when resting; most of them are intestinal tubes protruding through the abdominal wall defect, and can also be incorporated into the abdominal cavity. In severe cases, intussusception can occur, and the mass cannot disappear after protruding, accompanied by pain and severe abdominal pain, nausea, vomiting, anal stoppage, defecation and other symptoms of intestinal obstruction, which is due to intestinal tube prolapse and cannot be retracted, and intestinal tube infarction occurs.  Anyone can get a hernia. However, pediatric patients and middle-aged and elderly males are generally the majority of patients. In the middle-aged and elderly, because of the atrophy and degeneration of the abdominal wall muscles and the weakness of the abdominal wall, coupled with the increase in abdominal pressure in the elderly, such as chronic cough and constipation, the abdominal viscera protrude through the weak abdominal wall and form a “hernia”. forming a “hernia”.  Surgery is the only effective way to treat hernias, and early surgery should be performed when a hernia is detected, rather than waiting until an incarcerated hernia occurs and then being forced to operate in an emergency. Traditional surgical methods have severe postoperative pain and recurrence rates of up to 20%, which seriously affect the patient’s quality of life and make many patients afraid of surgical treatment. The only way to repair the abdominal wall defect is surgery. The surgical treatment of hernias can be grouped into three main categories.  The first category involves either suturing the edges of the defective tissue directly, or suturing the upper layers of the defective tissue in an attempt to cover the defect. This type of repair is often referred to as tension repair or traditional surgery. Tension surgery is like sewing up a hole in a garment with thread. This simple suture creates tension in the suture and is prone to post-operative pain and recurrence. Domestic and international data show that the recurrence rate of tension surgery is over 10%. This type of surgery is more suitable for young children and younger patients.  The second type of surgery is the tension-free hernia repair or tension-free hernioplasty. Tension-free hernia repair was invented in 1984 by Dr. Lichtenstein and his associates at the Lichtenstein Hernia Center in the United States. The method involves covering the hernia defect with a mesh patch that is highly compatible with human tissue. The logic of this method is equivalent to using silk to patch a hole in a silk dress. This method was named the Lichtenstein procedure. This approach has been rapidly adopted by surgeons worldwide because of its low recurrence rate, few complications, use of local anesthesia, no hospitalization of the patient after surgery, rapid postoperative recovery, and low cost.  The third category is the laparoscopic surgical approach. There are several laparoscopic surgical methods, and the ones that are currently well received by medical professionals and patients are transabdominal laparoscopic hernia repair (TAPP) and transperitoneal anterior unfixed mesh method hernia repair (TEP). The former involves the insertion of a patch into the patient’s abdominal cavity or preperitoneal space with the aid of a camera using different surgical instruments. This type of surgery has very good recent results, but requires a higher level of surgeon skill. Laparoscopic surgery is more suitable for patients with bilateral hernias and recurrent hernias in the elderly.  Tension-free and laparoscopic repairs do not suture the tissue to the tissue, so no tissue healing time is required. The healing process depends only on postoperative discomfort, which is minimal and requires only a few days of moderate analgesia. Documented medical records and clinical reports worldwide (USA, UK, Italy, Spain, Australia, France) prove that patients can go home within a few hours after receiving a patch tension-free hernia repair. Depending on the nature of their work and the degree of their desire, patients are able to go to work normally within 2 to 10 days after surgery. The pain persists for several weeks after the repair by the traditional method (tension method, where the tissue is just sutured together without a patch). The sutured tissue takes 4 to 6 weeks to heal.