What is an inguinal hernia?
A hernia is a weakness of the abdominal wall through which the contents of the belly can appear as a bulge. What usually appears is fat or intestine and that is why sometimes it can become complicated and hernia strangulations appear. To avoid these complications all hernias that are diagnosed should be operated. The most frequent area where hernias appear is the inguinal area and that is where inguinal hernias come from.
What are the possible causes of their appearance?
The appearance of hernias have multiple causes but the most general is that repeated efforts, increased pressure inside the belly, just forcing these weaker areas of the abdominal wall and is where they end up appearing these lumps that are hernias.
When do patients need surgery and what type of surgery is available?
For all patients who have been diagnosed with a hernia the only treatment that is effective is surgery. There are two types of surgery. The classic one, which is the open technique, which is usually done with mesh, with the Lietchtenstein technique. It consists of opening the skin and the aponeurosis of the muscle and in this area a prosthesis is placed, which are currently meshes, which give more consistency to the hernia area to prevent it from recurring.
Another type of technique is the minimally invasive technique, or laparoscopic technique. Currently the laparoscopic pre-peritoneal technique allows us to reach the area of the hernia from the posterior area, we separate the pre-peritoneum and in this area we place the prosthesis and we give more consistency to the weakened area of the abdominal wall, which is the area of the hernia. In this way we prevent intestinal and abdominal contents from passing through this area with its complications such as strangulation.
What are the latest developments in prostheses?
To prevent the mesh from moving, usually the technique used is to make a stitch, a suture, with which the mesh is anchored to the aponeurosis, to the ligament, to prevent it from moving. These stitches have the risk that in some cases they may trap a nerve, causing post-operative pain, or that they may cause some type of muscular hemorrhage or even some type of vascular lesion.
One of the latest advances that have appeared are meshes that are fixed without the need for stitches. Their mechanism is similar to that of Velcro. They are microhooks that adhere to the muscle tissue and prevent the mesh from moving. They are known as low weight meshes because part of the mesh is reabsorbable and normally, after some time, these hooks and part of the mesh have disappeared thus avoiding intolerances of the prosthesis itself.