Hernia repair is a surgical procedure used to treat abdominal wall or inguinal hernias, primarily aimed at correcting the displacement of intra-abdominal tissues. When intestines, fat tissue, or organs protrude abnormally through muscle or fascia defects, surgery can reposition the tissues and reinforce the weakened area to prevent complications such as strangulation or necrosis. This treatment is suitable for patients with severe symptoms affecting quality of life or those unresponsive to non-surgical treatments.
Hernia repair mainly divides into two categories: "Open Surgery" and "Laparoscopic Surgery." Open surgery involves making an incision at the hernia site, pushing the displaced tissue back into the abdomen, and then suturing the muscle or implanting a prosthetic mesh to strengthen the defect. Laparoscopic surgery involves three to four small incisions, using an endoscope to reposition tissues and place the mesh, offering advantages such as smaller wounds and faster recovery.
This treatment is applicable to various types of inguinal hernias, femoral hernias, incisional hernias, or groin hernias. Emergency surgery is required when patients experience severe pain, irreducible hernia lumps (irreducible hernia), or symptoms like bowel strangulation. Additionally, patients with long-term cough, heavy lifting, or increased intra-abdominal pressure causing symptom worsening are recommended to undergo surgery to prevent complications.
The surgery is usually performed under general anesthesia, but some patients may opt for epidural anesthesia. The operation lasts approximately 1 to 2 hours, depending on the type and complexity of the hernia. The choice of artificial mesh depends on the defect size and patient age; older patients may use lightweight meshes to reduce tissue reaction. There are no medication dosage issues, but surgical techniques should be adjusted based on the patient's physical condition.
Common risks include: infection, wound pain, seroma, etc. About 5-10% of patients may experience chronic wound pain or nerve compression symptoms. Serious complications such as mesh rejection, bowel injury, or deep vein thrombosis require close monitoring. Elderly patients or those with cardiovascular diseases may have increased anesthesia risks.
Patients should inform their medical history, especially regarding anticoagulant use, before surgery. Contraindications include: severe heart or lung failure, uncontrolled infections, coagulation disorders. Postoperative care includes avoiding heavy lifting for at least six weeks and following the physician's instructions for wound care.
Anticoagulant medications (such as warfarin) should be adjusted before and after surgery. Coordination is necessary with radiological examinations to avoid immediate post-surgical imaging. If combined with other abdominal surgeries, the surgical sequence and anesthesia risks should be evaluated. Combining physical therapy can accelerate recovery but should avoid excessive activity.
Studies show that patients with mesh implants have a five-year recurrence rate below 3%, significantly lower than the 15-20% with traditional suturing. Laparoscopic patients typically have a 50% shorter hospital stay and 30% less pain. Large randomized controlled trials confirm no significant difference in long-term outcomes between the two surgical methods, but recurrence risk is closely related to surgeon experience.
Non-surgical treatments include hernia belts that apply pressure to the defect, suitable only for temporary symptom relief or high-risk patients. Medications cannot cure hernias but can be used to control pain or inflammation. However, these methods do not prevent complications and are recommended only as short-term transitional solutions.
Generally, laparoscopic hernia repair may require 1-2 days of hospitalization, while open surgery may need 3-5 days. After discharge, avoid lifting heavy objects (more than 2-3 kg), bending, or vigorous activities for the first two weeks to reduce tension on the sutures. When showering, avoid direct water pressure on the wound; waterproof dressings are recommended for protection.
What are the long-term effects of repairing hernias with mesh?Mesh implants integrate with tissues and typically do not cause rejection or displacement in the long term, although they may be visible on CT scans. Rarely, patients may experience chronic pain or infection related to the mesh, such as unexplained redness, swelling, or persistent pain; immediate medical attention is advised if these occur. The recurrence rate with mesh repair is generally lower than with traditional suturing.
Can I shower or bathe normally during the healing period?Wound cleanliness is crucial for healing. Usually, a short shower is permitted 48 hours after surgery, but soaking baths (e.g., baths) should be avoided for at least two weeks. Waterproof dressings should cover the wound, and after showering, gently pat the area dry with a clean towel. Monitor for any discharge or redness.
What are the risk factors for recurrence after surgery? How can they be reduced?Major risk factors include chronic cough, constipation, premature strenuous activity, and untreated conditions increasing intra-abdominal pressure. Postoperative management includes maintaining a healthy weight, quitting smoking, and following the physician’s rehabilitation plan. Doctors may prescribe stool softeners or cough suppressants to reduce intra-abdominal pressure. Regular follow-up is essential.
What precautions should be taken when using painkillers after surgery?Doctors typically prescribe NSAIDs or mild opioids, which should be used cautiously with anticoagulants to prevent bleeding. Avoid alcohol while taking pain medication. If gastrointestinal discomfort or blood in stool occurs, stop the medication and seek medical attention. Non-drug methods such as ice packs or elevating the affected area are recommended first.
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