An Inguinal Hernia is a hole in an area of weakness in the muscles located at the groin area, most often on the right side. The Femoral Hernia is often mistaken for the Inguinal hernia, however, the Femoral Hernia is located lower and develops in the upper part of the thigh near the groin just below the inguinal ligament, where abdominal contents pass through a naturally occurring weakness called the femoral canal.
The Inguinal Hernia develops when fatty or intestinal tissues push through a weakness in the abdominal wall near the right or left inguinal canal. Each inguinal canal resides at the base of the abdomen. Both men and women have inguinal canals. In men, the testes usually descend through their canal by around a few weeks before birth. In women, each canal is the location of passage for the round ligament of the uterus. If you have a hernia in or near this passageway, it results in a protruding bulge, which is easy to see and feel, although not all are visible by the patient, especially when obese. It may be painful during movements like coughing, bending, or lifting.
There isn’t one cause for Inguinal Hernias. However, weak spots within the abdominal and groin muscles are thought to be a major contributor, with causes for this weakness around the inguinal canal, dependent on pre-existing conditions or previous surgeries in that area, lifestyle activity, weight, and heredity. Extra pressure on this area of the body can eventually cause a hernia.
Some risk factors that can increase your chances of this condition include:
In men, Inguinal Hernias are often easily visible as a bulge in the scrotum or groin, however, sometimes in women, it is easy to miss signs of an inguinal hernia. It is also important to determine that a perceived Inguinal Hernia is not enlarged lymph nodes, cysts, or testicular problems.
The following symptoms should be monitored and evaluated for a possible presence of an inguinal hernia.
Many people don’t seek treatment for Inguinal Hernias because it may be small or not cause any symptoms and sometimes treatment may not be necessary. However, if the hernia grows or becomes painful, prompt medical treatment can help prevent further protrusion and discomfort.
Dr. David W. Ford can usually diagnose an inguinal hernia during a physical exam and ask you to cough while standing so that he can check the hernia when it’s most noticeable. However, Dr. David W. Ford will want to establish that the perceived Inguinal Hernia is not enlarged lymph nodes, cysts, or testicular problems. If identification is problematic, additional tests may be ordered such as blood tests, urinalysis, ultrasound, and a computerized tomography (CT) scan.
If the hernia is established and when it’s reducible, it may be possible to push an inguinal hernia back into the abdomen when lying down on your back. However, if this is unsuccessful, the Inguinal Hernia may have developed into an incarcerated or strangulated inguinal hernia, requiring surgery.
Surgery, as the primary treatment for inguinal hernias, is a very common operation and has a high success rate.
If necessary, a reinforcement of the repair with the insertion of a synthetic strengthening mesh can be applied as a Hernioplasty. The surgery restores the tone and shape of the abdominal wall and normalizes the function of the surrounding organs, such as the intestines. The intestines will only be repaired if they have been damaged. Once structures are put into their proper place, Dr. David W. Ford will close the opening with sutures, staples, or adhesive glue.
As a Board-Certified General Surgeon, Dr. David W. Ford operates with a minimally invasive robotic system to repair ventral and inguinal hernias. This minimally invasive approach requires one or a few small incisions that doctors use to insert surgical equipment and a camera for viewing.
Robotically assisted Inguinal Hernia surgery utilizes an advanced robotic platform that is not autonomous, but is controlled by the surgeon who is seated in the operating room and operates via the Surgeon Console that controls the Patient Cart’s robotic devices, including various surgical instruments and a camera. The da Vinci Surgical System allows surgeons to perform minimally invasive hernia repairs with clinically supported precision and accuracy. Robotically assisted surgery uses a laparoscope (a thin lighted tube with a camera on the tip) that is inserted through one of several small incisions, made away from where the hernia has occurred. The images gathered from the laparoscope’s camera are high-definition 3D, which are sent to a monitor that Dr. David W. Ford uses to guide the surgical system during the operation. If needed, the abdomen can be inflated with a harmless gas (carbon dioxide), which creates space to allow the doctor to view the inside of the body.
For the Inguinal Repair, the abdominal wall at the groin is cut to allow Dr. David W. Ford to see the weakness in the abdominal wall. The surgery can also cut into the peritoneum (the sac created in the inguinal canal holding intestines) or it can repair and push fatty tissue, muscle and intestines back in without cutting the peritoneal sac. For women, sometimes an ovary can be caught in the inguinal hernia. Surgical mesh material is usually inserted to strengthen the weakened area and reconstruct the abdominal wall, although sometimes a suture-only repair is needed. After the procedure is completed, the small incisions in the abdomen are closed with a stitch or two or with surgical tape. Dr. David W. Ford’s use of the state-of-the-art da Vinci Surgical System in his robotically assisted hernia repair surgeries has allowed him to set a very high standard of expertise that can combine this method with traditional Open Surgery if required.
Many robotically-assisted surgical systems are FDA approved and in use today. However, many are specially designed for specific organs, procedures, or conditions, such as lung or pulmonary surgeries or knee and other extremity replacement surgeries. The da Vinci Robotic Surgical System is the premier system specialized in hernia repair surgery. Dr. David W. Ford is not only an expert board-certified surgeon but also certified in the use of this leading-edge technology.
This robotic platform offers Dr. David W. Ford fully wristed instruments and a 3D high-definition camera with 10x magnification. As a result, the repair can be done with more precision, and complex hernias can be fixed with small incisions. Furthermore, the robot doesn’t get tired and Dr. Ford sits during surgery, so there is less surgeon fatigue. For the patient, this translates into quicker recovery, less pain, and fewer complications. This is the preferred approach for medium to large hernias and many inguinal hernias as it combines the best of open and laparoscopic surgeries. Also, Dr. Ford is more likely to be able to sandwich the mesh between layers of the abdominal wall to keep the mesh from coming into contact with the intestines.
Other benefits of robotic hernia surgery include:
Should robotically-assisted surgical laparoscopic surgery be recommended as part of treatment for your hernia repair, Dr. David W. Ford and his team will have the best state-of-the-art technology at their disposal to usher in your recovery.
Da Vinci surgical systems are comprised of three components: surgeon console, patient-side cart, and vision cart.
The patient-side cart is positioned near the patient on the operating table. It is where the instruments used during the operation move in real time in response to your surgeon’s hand movements at the surgeon console.
A camera provides a high-definition, 3D magnified view inside your body. Every hand movement your surgeon makes is translated by the da Vinci system in real time to bend and rotate the instruments with precision.
The vision cart makes communication possible between the components of the system possible, and supports the 3D High Definition vision system.
"The da Vinci Surgical System allows me to make smaller incisions, resulting in reduced risk of infection, minimize scarring, reduce pain, and accelerate recovery time, allowing my patients to return to normal activities more quickly."
This traditional surgical method is employed when the hernia is very complex, and is most often used with inguinal or umbilical hernias. A complex hernia repair may require mesh removal, resection of the abdomen, or removal of extraneous skin or fat, and therefore is easier with open surgery.
The open surgery requires that an open incision be made in the abdomen, in the groin area over the hernia, and then the peritoneal sac is removed after the intestine or abdominal tissue is pushed back into place. Synthetic mesh material is usually placed to reinforce this repair and reduce hernia recurrences, however, sometimes, a suture-only repair is needed. The skin is usually closed with dissolvable stitches and glue.
Open repairs are classified via whether prosthetic mesh is utilized or whether the patient's own tissue is used to repair the weakness. Prosthetic repairs enable surgeons to repair a hernia without causing undue tension in the surrounding tissues while reinforcing the abdominal wall.
Repairs that utilize mesh are usually the first recommendation for the vast majority of patients including those that undergo laparoscopic repair. Procedures that employ mesh are the most commonly performed as they have been able to demonstrate greater results as compared to non-mesh repairs. Approaches utilizing mesh have been able to demonstrate faster return to usual activity, lower rates of persistent pain, shorter hospital stays, and a lower likelihood that the hernia will recur.
Hernia repair involves an operation, with overall one of two main approaches:
Post-operative Treatment of Inguinal Hernias will vary due to the repair surgical procedure chosen, the severity of the hernia, its location, and any complexities in either surgery or comorbidities of the patient.
Without any complications, a simple hernia repair only requires a hospital stay of a day or less, and most patients go home the same day. If internal stitches were substantial, a two-day hospital stay may be required. At first, you may need to rest in bed with your upper body raised on pillows, to help you breathe easier and lessen post-surgery hernia pain. Both cold and heat can help lessen some types of post-op pain.
Pain management efforts are more successful if you take the medication as soon as you start to feel uncomfortable, rather than waiting until the pain is severe. Should you require a refill, please plan ahead, as we do not call in prescriptions after hours. Scheduled medication, such as narcotics, cannot be called in and must be written in-person.
You may call or email with any problems, questions, or concerns below:
Prescription Refill Hours:
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Friday before 2:00 PM
Other alternative recommendations, as needed – Use at least one if have not had a BM for 2 days: