The definitive treatment of inguinal hernia is surgery. Conservative, i.e. non-surgical therapeutic approaches are available for large hernia gaps, which have a rather minimal risk of incarceration. For patients with such hernias and additional risks, a conservative therapy can be considered.
Hernial ligaments are used to prevent the fracture from protruding too far. Incarceration of an inguinal hernia that cannot be returned to the abdominal cavity even by a surgeon is an urgent surgical indication. In addition to fatty tissue from the abdominal cavity, intestine in particular can become trapped. In these situations an intestinal obstruction occurs, which can only be treated surgically.
Surgical therapy
The whole history of inguinal hernia surgery is characterized by efforts to develop a surgical method that eliminates or at least minimizes the risk of recurrence of the hernia. Such an operation does not yet exist. Several dozen methods of inguinal hernia surgery were applied in the last century.
In most of them the body’s own material was used to close the hernia gap. In the 80’s and 90’s techniques were also developed in which connective tissue supporting plastic nets were implanted. With the development of minimally invasive surgery (MIS), hernia gaps were also closed laparoscopically.
Nowadays, there are three main methods of closing hernia gaps in Germany (but also in English-speaking countries), and there are numerous clinics that also use surgical procedures other than those listed here. These are not to be considered “better” or “worse”. Rather, the experience of the operating surgeon with the respective method plays an essential role in the success of the operation.
Operation methods
The most frequently used surgical methods of inguinal hernia:
- Operation according to Shouldice
- Operation after Lichtenstein
- Laparoscopic surgery (by means of abdominal or abdominal wall endoscopy) = minimally invasive surgery of the inguinal hernia
Operation according to Shouldice
The body’s own tissue is used to close the hernia gap, whereby the connective tissue leaves are double sutured. This is hoped to increase the stability of the affected area. This method is often preferred for young people with smaller hernia gaps.
