Due to the physiological characteristics, inguinal hernia occurs more often in men than in women. Adults suffer from an unpleasant defect due to weak connective tissue, increased pressure on the peritoneal wall, excess body weight, and unbearable stress. Often, pathology is observed in infants. - the only solution that allows you to stop the increase in pathogenic tissues and prevent complications in the form of infringement of the fallen out organs or disruption in their work.

Surgery is the only way to save tissue from destruction

Indications for removal of inguinal hernia in children and adults

An inguinal hernia is a formation that forms as a result of fragments of abdominal organs entering the groin canal.

The indication for the removal of a hernia in the groin is precisely its presence. A prolapse of the small intestine or omentum into the inguinal canal is not treated with medication.

Depending on the localization of the pathology, there are:

bilateral inguinal hernia(more often it happens in women and girls) - the loss of fragments of internal organs occurs simultaneously on both sides of the groin;
oblique (congenital pathology in boys is more common) and straight inguinal hernia - the direction of protrusion (obliquely along the groin canal and directly to the external opening);
inguinal scrotal hernia(in men and boys) - the hernial sac descends into the scrotum, which is accompanied by testicular edema.

An inguinal hernia can be acquired - as a result of weak walls of the peritoneum, heavy loads, trauma to the inguinal canal, tearing cries in children - and congenital (formed in the fetus even before childbirth).

First of all, the indication for the operation is negative symptoms:

pain in the place of protrusion;
disruption of the intestines;
the inability to correct the contents of the hernia back after its protrusion.

After the operation, power physical activity is prohibited, only light gymnastics is allowed

Possible complications after surgery

In the early postoperative period, there is a high likelihood of developing complications such as:

hematoma at the incision site;
swelling of soft tissues;
suppuration of the wound;
divergence of seams;
blockage of blood vessels at the site of the manipulation;
minor bleeding.

In case of an increase in body temperature, severe pain and problems with urination, be sure to seek medical help. A dangerous consequence of the operation is the development of acute inflammation in the abdominal cavity and further peritonitis.

A late complication of the removal of an inguinal hernia is considered its reappearance.

Contraindications

Hernioplasty is contraindicated:

It is forbidden to perform an operation while carrying a child - it may affect the fetus

with diabetes mellitus in severe form;
with a history of stroke and heart attack;
during the period of bearing a child;
with severe impairment of the functions of the lungs, kidneys or liver.

If it is impossible to carry out the operation, the patient is prescribed supportive therapy - wearing a bandage, limiting physical activity, adjusting nutrition.

Where and how much does the operation cost?

Routine surgery to remove a hernia in the groin is done in both public hospitals and private clinics.

In the municipal clinic, open hernioplasty is done free of charge as part of the compulsory health insurance. It takes 1-5 months to wait in line.

In paid clinics, the cost of the operation depends on the method and qualifications of specialists:

open method - from 25,000 rubles;
laparoscopy - up to 90,000 rubles.

The cost of hernioplasty is influenced by the material of the prosthesis, the type of anesthesia, the volume of the operation, and the length of hospital stay.

In order to prevent protrusion of organs - take care of the treatment in time

The protrusion of organs into the peritoneum is rarely amenable to conservative treatment. The only way to get rid of a hernia in the groin- to operate on her. Otherwise, the pathology is dangerous by infringement, which leads to rapid necrosis of the clamped tissues, and threatens with peritonitis, intestinal blockage, scrotal edema (depending on the location of the hernia). The operation is carried out by an open and laparoscopic method, which allows to replace the fallen organs and to prevent the recurrence of the disease as much as possible.

After surgery to remove an inguinal hernia, sometimes there are some complications. There are many reasons for their occurrence - from the error of the surgeon who performed this operation to the physiological characteristics of the patient's body. And, despite the fact that the operation to remove a hernia is not difficult, the consequences of this procedure can be very serious.

Occasionally, patients have an initial injury to the ilio-splanchnic nerve. This can happen if the man has previously undergone surgery. Therefore, if we are talking about the re-formation of a hernia, then the doctor should know about all the diseases from which the patient suffered before. After all, damaged nerves lead not only to severe pain syndrome, but also to muscle tissue atrophy.

There are several possible postoperative complications, let's get acquainted with them in more detail.

Table. Possible consequences after surgery

Name	Short description
	A similar phenomenon may be the result of the surgeon's negligence or inexperience - damage to the cord can occur at the time of removal of the hernial sac. In addition, such a complication appears if the patient has previously undergone a similar operation. To avoid this phenomenon, the cord should be isolated, released from the scar tissue. As for the consequences of such an injury, they, first of all, include interruptions in the work of the spermatogenic and hormonal levels, which, in turn, can cause infertility in the future. Moreover, the testicles may atrophy.
	To avoid its appearance immediately after the operation, ice should be applied to the wound (for at least two hours).
	This complication may appear due to incorrect treatment of the hernia. This usually occurs during the removal of a sliding hernia of the cecum or sigmoid colon. Damage can be avoided provided that the hernial sac is palpated. Also, during dissection of the latter (if during the surgical procedure, plastic of the patient's tissues is used or there is a high dressing), the bladder may be damaged.
	One of the most dangerous complications arising from negligence during the operation and manipulation of the wound, as well as excessive trauma to soft tissues with surgical instruments. In such cases, antibiotic treatment is performed.
	If the surgeon sutures too rough, it can damage the hip joint. Therefore, it is advisable to investigate in advance all areas at risk. Sometimes, when suturing, bleeding appears, which is stopped by removing the needle and pressing the wound with a finger or a swab. Sometimes you have to expose the vessel, squeeze it and suture it.
	What is characteristic, dropsy in this case can be both one- and two-sided. This kind of consequence can be detected visually: the patient's scrotum swells (on one side or on both sides at once, depending on the type of dropsy). To eliminate this defect, a second operation is required. The development of dropsy is also considered one of the most common postoperative complications.
	In most cases, thrombosis affects the elderly and those who lead an inactive lifestyle. Symptoms of thrombosis include pain in the calves; to alleviate the patient's condition, anticoagulants (for example, thrombolytics) are prescribed. These drugs significantly improve the "well-being" of the deep veins.
	This can happen again if the patient does not adhere to the postoperative regimen or does not follow the doctor's recommendations.
	The result of an incorrect rehabilitation period.

As noted earlier, complications can arise through the fault of not only the surgeon, but also the patient himself. That is why it is so important to follow all the doctor's recommendations, as well as strictly observe the rehabilitation period. Consider what this period represents.

Video - Important points of the postoperative period

How long does rehabilitation take?

The duration of the rehabilitation period largely depends on the anesthesia applied by the surgeon. So, if the anesthesia is local, then rehabilitation will take a little time: after a couple of hours the patient is released from the hospital, but provided that there are no complications. Although the patient should still return there regularly for dressings, during which the progress of recovery will be monitored. The first dressing should be carried out in the evening (as a rule, such operations are done in the morning), and you should not worry if there is discharge at the same time - there is nothing wrong with them. But in the case of general anesthesia, the initial stage of rehabilitation can take one or two days.

This is followed by an outpatient rehabilitation period, which can be one or two weeks. For this period, rest, proper nutrition, and also the fact that the patient spends a lot of time in bed are important. In addition, he must regularly visit a doctor who can identify complications and, if necessary, make adjustments to the treatment.

Note! During the period of postoperative rehabilitation, any physical activity should be excluded. After some time, the patient is prescribed special exercises that reduce the risk of hernia recurrence and the development of complications.

The attending physician can prescribe the wearing of a special bandage, although today such devices are used less and less, because modern surgical methods provide reliable fixation of the site of hernia appearance by means of mesh implants. Therefore, such a bandage will only be beneficial at first, until the pain disappears and physical activity is restored.

Postoperative nutrition

Thanks to a properly composed diet, possible complications can be avoided, and the rehabilitation itself will be faster. The patient is advised to eat only liquid food, and he should eat slowly, in small portions (at least four times a day). The main condition is that food should be rich in protein, because it is the main "building material" of the human body, allowing you to recover as quickly as possible.

The following foods are high in protein:

a fish;
milk, cottage cheese;
chicken eggs and meat;
buckwheat.

Note! You should also exclude from the diet some foods that disrupt the normal functioning of the gastrointestinal tract and provoke gas formation.

So, the patient should refuse sweets, yoghurts, fermented milk products and fruits. The specific menu should be prescribed by the doctor. Finally, during rehabilitation, you need to give up cigarettes, alcohol and coffee, sour fruits, soda.

About physical activity

Two weeks after the surgical procedure, you can start gently and gradually return to your previous activity, although weights should not be lifted for about six months. If these recommendations are violated, then the hernia may return, but doctors also do not advise spending all the time in bed. When the pains disappear and the man feels that strength is returning to him, you can begin to walk a little and do simple physical exercises.

Light gymnastics in combination with special stimulating exercises will allow the body to quickly return to its previous shape. There are quite a few similar exercises, the most popular of them are listed below.

Exercise number 1

The patient gets on all fours, bends all limbs, leaning on the elbows and knees. Then he alternately raises the left and then the right leg.

Exercise number 2

The patient lies down on a previously laid mat, hands along the body. Then he raises his straightened legs (about 45 degrees) and alternately crosses them (exercise "Scissors"). The number of repetitions increases over time.

Exercise "Scissors"

By the way, the "Bicycle" is performed in the same position: a man raises his bent legs and imitates pedaling.

Exercise "Bicycle"

Exercise number 3

The patient lies on his side, pulls his hand forward and rests his head on it. In this case, the legs should be straight. You need to try to raise one of them, after several repetitions, the side changes.

Exercise number 4

The patient puts his feet shoulder-width apart and performs squats (possibly incomplete), after which he does two or three push-ups. If traditional push-ups are too difficult, then you can lean on your knees.

Note! It is necessary to perform all these exercises regularly, but at the same time you need to monitor your well-being. A man should not feel any pain or discomfort.

The number of repetitions should increase daily, in the future, other exercises can be included in the complex.

Video - Hernia in the groin

As a result, we note that postoperative complications after removal of a hernia can be the most serious, but if the operation is performed by an experienced qualified surgeon, they may not appear. Of course, even professionals sometimes make mistakes, but the probability is still reduced. At the same time, it is necessary to follow all the doctor's recommendations regarding the rehabilitation period, since some of the complications (for example, recurrent hernia) arise precisely because of this.

An inguinal hernia in the postoperative period often gives a relapse if a person does not follow medical prescriptions. The duration of recovery depends on the severity of the clinical case and how the operation went. Recovery from surgery includes specific exercise, diet, and wearing a bandage. In the presence of pain after surgery, medications are prescribed.

Features of the recovery period after surgery

After laparoscopic surgery to remove a hernia in the groin, the patient can go home after a few hours (sometimes in a day). The doctor examines the patient to make sure that he can move by himself, he does not have severe pain, is able to serve himself and eat normally.

Despite the fact that the risks of complications during hernioplasty are extremely small, the patient after surgery will experience a slight feeling of discomfort, there may be moderate abdominal pain, but this condition is the norm.

There are no special restrictions after the operation, but there are some recommendations, the observance of which will help to avoid complications, for example, a temporary ban on driving a car is imposed. Within the next 2 days after the operation, there will still be residues from the anesthesia used in the blood, which can reduce attention and concentration.

Special attention should be paid to the postoperative scar. The seam cannot be wetted for 2-3 days, therefore, before performing hygiene procedures, it must be carefully closed.

Bandage

Whether there is a need to wear a bandage after surgical treatment of a hernia in the groin, the attending physician decides on an individual basis. Wearing a bandage is a must for women, because in men, the muscle corset is much stronger. But the need to maintain the muscles also depends on how large the removed hernia was, and whether there are risks of complications and its recurrence.

Because the cause of the appearance of a hernia in the groin is the wear of muscle tissue, then wearing a bandage in the postoperative period will give the muscle corset a rest, the abdominal muscles will not experience excessive pressure.

In most cases, doctors recommend that patients use a bandage for the first weeks. the fixation bandage reduces the pressure in the abdominal cavity. Also, in the area of the postoperative scar, the degree of compression is reduced, due to which the healing and recovery time is much shorter.

If the doctor did not prescribe wearing a bandage immediately after the intervention, then during the rehabilitation period, when a person begins to perform physical therapy exercises, he will be needed. This is to ensure that the oblique abdominal muscle is supported and not stretched.

After surgery, special attention is paid to the diet, nutrition is aimed at preventing constipation and normalizing the stool, so that a person does not push when going to the toilet, because this will increase the pressure in the abdomen. Diet food has the following features:

the basis of the diet is liquid dishes;
fractional meals - meals are taken up to 5 times a day, portions should be small;
thorough, slow chewing of food;
emphasis on protein foods.

The following products should be present in the daily menu:

poultry meat;
lean fish varieties;
eggs;
dairy products;
cottage cheese with a minimum percentage of fat.

After an inguinal hernia operation, it is recommended to cook food steamed, baked or boiled.

coffee and strong tea;
alcoholic and alcoholic drinks;
fried and smoked;
spices and spices;
marinades, canned meat, fish and vegetable products;
sparkling water;
sour fruits, vegetables and berries.

These foods are quite heavy, they cause a feeling of heaviness, flatulence and bloating, and this additionally puts pressure on the groin area.

The correct combination of products also plays an important role. It is not recommended to eat meat and heavy side dishes at the same time, because this will cause a heaviness in the abdomen, digestion problems, or constipation.

Gymnastic set of exercises

2-3 weeks after surgical removal of a hernia in the groin, it is necessary to refrain from any physical activity so as not to create undue stress on the walls of the inguinal canal. When the postoperative scars have healed, physical rehabilitation can begin.

The load should be increased gradually. First, the patient performs light, mostly passive movements. If there is no pain and any discomfort when doing light exercises, the degree of stress increases. During rehabilitation after the removal of an inguinal hernia, the following exercises are performed:

If, during the exercise, a person notes the appearance of pain, the exercise should be stopped immediately and the doctor should be reported about the incident. If the patient before the operation was engaged in strength sports, for example, bodybuilding or powerlifting, it will be possible to return to training no earlier than 3-5 months later.

Why do pains occur after surgery?

The causes of pain syndrome can be different. Pain can be a normal physiological phenomenon arising from the healing of soft structures, the integrity of which was violated during surgery.

If the pain is intense, its intensification is noted, this may be a sign of such a complication as the addition of an infection, but in this case, other signs will be present: reddening of the skin around the surgical scar, the appearance of weakness, an increase in body temperature.

Pain in the postoperative period can be caused by the fact that a person does not correctly perform physiotherapy exercises, for example, is engaged in excessively intensely, which could cause a divergence of the sutures. If the pain is caused by the gradual overgrowth of soft structures, pain relievers are prescribed. When an infectious process is attached, it is necessary to carry out treatment, which consists in taking antibiotics.

Possible complications

After surgical removal of an inguinal hernia, the following complications may develop:

accession of infection with further inflammation and suppuration of the postoperative scar;
recurrent hernia - occurs when the patient neglects the rules of the rehabilitation period;
hematoma - cold compresses are used to stop it; if the hematoma is large, a puncture may be needed to remove it;
damage by a surgical instrument to the roots of nerve endings, the integrity of the walls of blood vessels;
dropsy of the testicle, the appearance of which requires surgical treatment;
the formation of blood clots with blockage of blood vessels by them - this complication occurs mainly in elderly patients and people with weakened immunity and chronic diseases.

Therapy for complications is selected depending on their type and severity. If nerves and blood vessels have been injured during surgery, surgery is required to restore their integrity. If blood clots are observed, anticoagulants and thrombolytic drugs are prescribed.

Some complications are associated with medical errors, but in most cases, the patient himself is to blame for their occurrence, because does not follow medical recommendations during rehabilitation, does not wear a bandage, does not want to follow a diet, or returns to active physical activity too early.

Prevention

An inguinal hernia is a pathology that often relapses, despite its effective surgical removal. It is possible to avoid the appearance of a hernia by observing preventive measures. These include proper nutrition, giving up bad habits, and exercising regularly.

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These preventive measures will help to avoid the re-development of the pathological condition. Careful implementation of the doctor's recommendations and prescriptions is the key to effective and quick recovery after the operation. The choice of a qualified and experienced surgeon also plays an important role.

After surgery to remove an inguinal hernia, the main focus is on eliminating the causative factor of the disease - weak muscles through which the abdominal organs penetrate into the inguinal canal of a woman or man. The duration of rehabilitation directly depends on the chosen method of radical treatment and the characteristics of the patient's body. Some patients after treatment do not feel pain, recover quickly without negative consequences, but most patients require long-term observation and prevention of complications for several months.

On an outpatient basis, the patient stays up to 10 days after the operation, during which time the doctor examines the abdominal cavity and inguinal canal, prescribes medications, selects optimal nutrition and therapeutic exercises.

The patient observes bed rest for 5-10 days, avoids even small physical activity and eats mainly liquid food.

Rehabilitation rules after treatment of an inguinal hernia

The postoperative period in the case of laparoscopy is shortened, since a small suture is applied. The wound heals quickly, the patient is immediately discharged home. It takes no more than a week, on the 7th day the suture is removed, for some time a person may be disturbed by pain and discomfort, but these are normal conditions in the period after hernia repair.

Late recovery period

Discharge home rehabilitation includes the following activities:

In the first days, do not lift more than 2 kg, increase the load gradually, start gymnastics only after being prescribed by a doctor;
Purchase and wear a support bandage while doing housework, walking, and when pain occurs;
Drink plenty of fluids, but do not get carried away with coffee and energy drinks;
Change the dressing daily, if necessary and twice a day, to keep it always clean;
Eat at least 4 times a day in small portions, excluding heavy foods that provoke constipation and gas formation.

Sick leave lasts up to 2 months, but after 30 days the doctor can prescribe physiotherapy exercises.

Pain syndrome and its treatment

The first time after the operation of an inguinal hernia, you can observe pain and discomfort after eating, when coughing. For the first time, pain appears after the first attempt at independent movement and is localized in the seam area.

Causes of pain and severity after hernia repair:

As a result of wound healing and an increase in tissue sensitivity after the incision;
Postoperative edema, problem healing;
Inflammation, excessive tissue injury during surgery;
Divergence of seams;
Reappearance of a hernia.

In the postoperative period, the patient takes painkillers, but they do not guarantee the exclusion of pain. If the patient's rehabilitation takes longer, specific symptoms appear, including pain, indicating the development of complications. In this case, antibiotics, vitamins, immunomodulators, anti-inflammatory drugs and drugs that improve regeneration are prescribed.

Postoperative complications

Common complications of an inguinal hernia during rehabilitation:

Suppuration of the wound: accompanied by pain, fever, discharge of purulent contents;
Recurrence of the disease: recovery in the late period includes adherence to a diet and wearing a bandage, but ignoring the rules often ends up with repeated protrusion of organs after an inguinal hernia operation;
Hematoma and vascular damage: manifested in the case of improper dressing, when the wound is squeezed and cold compresses are applied. Such complications are eliminated by puncture;
Dropsy of the testicle is common when choosing hernioplasty. The disease is characterized by an enlargement of one or two testicles, the appearance of pain, heaviness when walking;
Vein thrombosis and nerve damage: Complications affect the sensitivity of the hips and scrotum, more common in older patients. Treatment includes the use of anticoagulants, fibrinolytics, thrombolytic and antiplatelet agents;
Intestinal dysfunction is associated with incomplete processing of the hernial sac. Complications related to digestion occur mainly when removing a sliding hernia;
Infection and inflammation in wounds: Recovery from treatment can be complicated by improper wound care, with serious consequences. In this case, antibiotics are prescribed.

After the removal of the inguinal hernia, the patient is in the hospital for some time. But even after being discharged home, the rehabilitation period does not end; in some cases, full recovery may take more than one month.

First week after surgery

The first days after surgery, the patient needs maximum rest - as little movement as possible, bed rest is preferable. Also at this time, a person must take a number of medications. First of all, these are painkillers, which, depending on the patient's condition, can be prescribed even after discharge from the hospital. With an inguinal hernia after surgery, antibiotics can also be prescribed to prevent the development of infections. However, in modern practice, this is not at all an obligatory treatment item, more often such therapy is prescribed when symptoms of the inflammatory process are already manifesting.

Frequent dressings are an important part of rehabilitation. The first one takes place already on the day of the operation in the evening, then the sutures are examined once or twice a day.

With an inguinal hernia in the suture area, small discharge may be observed, but if there are no other symptoms (inflammation, suppuration, fever, etc.), they are considered the norm and do not require additional treatment. If the wound heals well, and the patient has no complications, the stitches can be removed in a week, and the person can be discharged home.

Rehabilitation at home

The patient should be as responsible as possible during the recovery period outside the hospital. Failure to follow the recommendations can lead to serious complications, in particular, to the divergence of the seams.

It is important to remember these rules:

Refusal to lift weights for the first 20 days (permissible weight - no more than 5 kg).
No smoking. A bad habit can cause a severe cough, which, in turn, will provoke excessive stress and damage to the seam.
Physiotherapy exercises only as prescribed by a doctor.
To monitor the cleanliness of the dressing, in case of any discharge from the suture, consult a surgeon.
Go to the toilet on time. An enlarged bladder can press on the seam.

Special attention should be paid to nutritional therapy, which is recommended to be observed for at least a month after the operation:

Drink plenty of fluids.
Eliminate foods that can cause constipation or bloating.
Eat small meals, 5-6 times a day, chew food well.
Eliminate fried, spicy, salty foods.
Refuse alcoholic beverages, soda, coffee.
Fill the diet with proteins (meat, dairy products, fish), which help to restore tissue.

Why do you need a bandage

During the rehabilitation period, patients are often advised to wear a bandage as a preventive measure. Indeed, an inguinal hernia after surgery can bulge out again, move, etc. The bandage helps:

Distribute the load evenly.
Avoid muscle stretching.
Reduce pressure on the scar, which means faster healing.
Reduce pain initially.