A hernia, commonly known as a hernia, is a part of the body’s tissue or organ that leaves its original site and enters another site through a gap, defect or weakness in the body. There are umbilical hernia, inguinal hernia, hiatal hernia, incisional hernia, surgical recurrent hernia, white line hernia, femoral hernia and other types. Most of the hernias are caused by coughing, sneezing, excessive exertion, abdominal hypertrophy, straining to defecate, pregnancy in women, excessive crying in children, and degenerative changes in the strength of the abdominal wall in the elderly.
Clinical manifestations
They are classified as inguinal hernia, inguinal hernia, femoral hernia, umbilical hernia, white line hernia, incisional hernia, incarcerated hernia, strangulated hernia, etc.
General symptoms: protruding when standing, disappearing when lying on the back, and returning to the abdominal cavity with pressure. However, incarcerated hernia and strangulated hernia are painful and difficult to push back into the abdominal cavity. If left to develop, hernias are prone to adhesions and intussusception, and should therefore be treated early.
Types by site of disease
Inguinal hernia: This type of hernia can appear and occur at any age, but peaks in early childhood and occurs in 80% – 90% of boys, followed by the elderly.
Abdominal wall hernia: this type of hernia occurs mainly in the area around the navel, and women account for the majority of hernia patients. Most occur between the ages of 20 – 50 years.
Umbilical hernia: occurs in the navel, which is raised in a circular pattern inside the navel. Umbilical hernia 10% —-20% occurs in infants, children, followed by adult women is more common.
Scrotal hernia (scrotal hernia): In men, it occurs in the scrotal area and produces scrotal hernia, which in severe cases is significantly enlarged and makes walking extremely difficult. In women, it occurs in the ovary area, resulting in significant swelling of the lower body with painful swelling. This hernia can be treated surgically in addition to using the formula for diaphoretic hernia.
Incisional hernia: This type of hernia occurs at the site of an earlier original surgical incision scar. Incisional hernias may occur months or years after the surgical procedure.
The hernia first affects the patient’s digestive system, resulting in symptoms such as lower abdominal cramping, abdominal flatulence, abdominal pain, constipation, poor nutrient absorption, easy fatigue, and decreased physical fitness. Since the inguinal region is adjacent to the genitourinary system, elderly patients are prone to bladder or prostate diseases such as frequent urination, urgent urination and increased nocturia; children may be affected by the normal development of testicles due to the extrusion of the hernia; and middle-aged and young patients are prone to sexual dysfunction. The intestinal canal or omentum inside the hernia sac is prone to inflammatory swelling caused by extrusion or collision, resulting in difficulty in hernia retraction, which can lead to intestinal obstruction, intestinal necrosis and other dangerous situations.
Methods of treatment
Conservative treatment There are two main types of conservative treatment: drug therapy and hernia belt therapy
Drug therapy: It can relieve the symptoms of abdominal distension, abdominal pain and constipation caused by hernia, thus reducing the hernia; the shortcoming is that it cannot control the hernia prolapse and cannot achieve the root cause. Commonly used Chinese medicines include: Lishui Hernia Dissipation Formula, Hernia Internal Dissipation Pill, Orange Kernel Pill, Tonic Chinese Medicine Pill, etc.; or cinnamon powdered and mixed with vinegar and gauze wrapped around the umbilicus.
Hernia belt therapy: It can quickly stop the protrusion of hernia, which can effectively stop the development of hernia and relieve the symptoms of abdominal distension, abdominal pain and constipation caused by hernia. The disadvantage is that it is inconvenient to use and cannot cure the hernia.
2.Surgical treatment
There are three types of surgical treatments: traditional hernia repair, tension-free hernia patch repair, and laparoscopic hernia repair
Traditional hernia repair: The tissues adjacent to the abdominal wall defect are pulled together and sutured, which is a treatment method with too much tension and prone to recurrence.
Tension-free hernia patch repair: the abdominal wall defect is repaired with artificial material, just as we use a good piece of cloth to mend a hole in a garment. Since the surrounding tissues of the defect are not forcibly sewn together, there is no tension problem, hence the name of this procedure.
Hernia laparoscopic repair: This is a hernia repair or hernia patch repair done through a laparoscope.
Comparison of the three types of surgical treatments
Traditional hernia repair: there is a large incision (about 6-8 cm long); hospitalization takes about 7-10 days; routine anti-infection; postoperative pain and other discomfort are common; recurrence rate is about 20%; full recovery time is about 3 months for a normal hernia and 6-12 months for an extra large hernia.
Tension-free hernia patch repair: there is a medium incision (about 4-6 cm long); hospitalization is required for about 3-7 days; routine anti-infection; recurrence rate is about 1%; full recovery time is about 1 month for common hernia and about 3-6 months for extra large hernia.
Hernia laparoscopic repair: 3 small incisions (about 1 cm long); hospitalization of 4-7 days; routine anti-infection; general anesthesia is necessary; complications such as poking and placing the mirror and pneumoperitoneum may occur; recurrence rate of about 10%; full recovery time of about 1 month for common hernia and about 3-6 months for extra large hernia.
How to choose the correct treatment method
The treatment plan for hernia can be selected according to the following procedures: length of illness, severity of illness and presence of other diseases.
1. Hernia belt treatment can be considered for infants and children within 1 year of age. If the condition is not too severe, about 90% of the infants can be cured with this method and surgery can be avoided.
Most patients should consider surgical treatment.
3. In elderly and frail patients or those with other serious diseases that contraindicate surgery, a medical hernia belt can be used to stop the protrusion of the hernia mass during the day after the hernia contents are retracted.
However, long-term use of the hernia belt may cause the hernia sac neck to become thick and tough due to frequent friction, which increases the incidence of hernia impaction and often promotes adhesion of the hernia sac to the hernia contents, making surgical treatment difficult.