Inguinal Hernia

(angin pasang)

Dr Yang Boon Yon

General Surgeon
 Inguinal Hernia
• Hernia is protrusion of intrabdominal content
into an area where it normally should not be.
• Inguinal hernia is bulging of intrabdominal
content at the groin region.
• Inguinal hernia
bulges out through
the inguinal orifice.
• In man, the inguinal
orifice is an opening
for the passage of
testicular artery
whereas in woman
it is an opening for
round ligament.
 Type of inguinal hernia
• Indirect
– Congenital defect at at
inguinal orifice
• Direct
– Weakness of the
abdominal wall muscles
at the groin region.
 Risk Factors
• Congenital defect
• Increased of Age
• Previous surgery
( appendicectomy)
• History of hernia repair
• Smoking with chronic cough
• Straining
• Heavy lifting (increase
intrabdominal pressure)
• Weight Gain
 Symptoms
• Bulges at the groin region or at the scrotum
– Sometimes reduce when lying down
• Pain, discomfort, burning sensation of
heaviness at the groin region
• More severe when
– The bulge becomes bigger and does not reduce
which it usually does
– Severe pain with redness and fever
– Symptoms of intestinal obstruction
 Diagnosis
• Clinical examination
• Ultrasound abdomen
• CT abdomen
 Treatment
• Watchful for
asymptomatic patient
• Open surgery
– A sizeable incision made
at the inguinal region
– Repair the hernia site
with a mesh
– The surgery is done
under general, regional
or local anaesthesia
• Minimally Invasive
surgery
– Laparoscopic hernia
repair
– Small wound
Laparoscopy
– Less pain
– Hasten the recovery

Open surgery
 Hernia Truss
• Relieve the hernia
symptoms
• DOES NOT HEAL THE
INGUINAL HERNIA
 Myths of Inguinal Hernia
• Hernia can be healed by itself?
– NO, hernia is a mechanical defect.
– It cannot be left alone as it will cause complication
like strangulation which is life threatening
• Exercise can cure the hernia by strengthen the
abdominal wall?
– NO, once there is a defect, or hole, hernia will be
developed
– Straining exercise may exacerbate the symptoms
of the hernia
• Hernia can be cured by medicine or
alternative treatment (urut)?
– No, the mechanical defect need to be repaired
mechanically with a mesh
– The repair can be done laparoscopically (minimally
invasive surgery)
• Hernia surgeries are very painful
– Hernia surgeries are performed under general or
regional anaesthesia, so that the procedure is
painless
– Laparoscopic surgery can minimise the pain and
hasten the recovery
– Although the open surgery involves a sizeable
incision but the pain is bearable
• Post operative recovery is long
– Usually patient will be able to back on his/her feet
on day one or two postoperatively
– However, laparoscopic surgery has a quicker
recovery time than open surgery