Inguinal hernia: Current repair options for adult patients

Dubai, UAE, 2021-Nov-24 — /EPR Network/ — Being one of the most common forms of hernia in adults, inguinal hernia repair is one of the most often performed surgical procedures in the world. Research estimates that 27-43% of men and 3-6% of women are at risk of developing inguinal hernia in their lifetime. Although effective surgical interventions are available, around 5% of adult patients tend to suffer from a recurrence, following a primary inguinal hernia surgery.

To combat this issue, surgeons are now opting for evidence-based hernia treatment recommendations, which vary for individual patients and cases. 

Renowned colorectal surgeon, proctologist, and hernia surgeon in Dubai, Dr. Antonio Privitera has performed countless hernia repair surgeries and notes his findings, “Although we are aware of over hundred different repair techniques to correct inguinal and femoral hernias, some basic principles must be followed. In fact, inguinal hernia repairs should not be under tension that is the main factor for hernia recurrence. The use of meshes allows to patch the hernia defect, providing a solid repair, and without tension, Also, the absence of tension, reduces postoperative pain and the scar tissue induced by the mesh, forms a strong new wall.”

For inguinal hernia, some of the recommended procedures include laparoscopic transabdominal preperitoneal repair (TAPP), extraperitoneal repair (TEP), and Lichtenstein techniques. TAPP and TEP repair are both laparoscopic techniques, although there are significant differences in the way they are performed. TAPP is performed by going into the peritoneal cavity and opening a preperitoneal pocket at the hernia site. This procedure has a higher incidence of visceral injury and postoperative pain but is quite straightforward. TEP is less invasive, avoids entry into the abdomen, and has lesser chances of vascular and visceral injury. However, the procedure is less easy to perform and less comfortable for a surgeon used to laparoscopic abdominal procedures for other pathologies.

With that said, Lichtenstein’s tension-free repair is still one of the most performed hernia surgeries to treat primary inguinal hernia due to its effectiveness and simplicity. If the patient requires an open procedure, the Lichtenstein technique using glue to fix the mesh, maybe an alternative to the use of suture materials.

“Options of hernia treatment are discussed with the patient in detail. This helps the patient to have realistic expectations regarding recovery and chances of recurrence,” says Dr. Privitera.

It is to be noted that emergency inguinal hernia repair can either be performed with laparoscopic surgery or with an open approach. In case the field is contaminated with bowel content, the use of a mesh may not be always appropriate because of the high risk of infection. Today, to improve the outcome of inguinal hernia repair, international hernia societies are following evidence-based guidelines for the standardization of procedures and ensuring better patient care.

If you are looking for a reputed hernia doctor to consult, call +971 55 318 8469 to book an appointment today with Dr. Antonio Privitera, hernia specialist in Dubai London Clinic.