This usually manifests itself in the form of a visible protrusion in the groin area. In addition to a discomforting feeling, pain of varying degrees can also be a symptom of the disease. This often occurs after exertion such as prolonged standing or walking. Femoral hernias occur where the blood vessels of the legs pass through the pelvis. Abdominal organs can also pass through this femoral portal.
The treatment of inguinal and femoral hernias consists of surgical treatment. Several surgical procedures are available for this purpose. In adult patients, non-dissolvable plastic mesh is used to reinforce the abdominal wall. This reduces the likelihood of the hernia recurring at a later date. Minimally invasive techniques have proven to be particularly gentle with cosmetically pleasing results. These are referred to as TEP or TAPP, depending on the technique used, although the results of the two techniques do not differ. These now represent the gold standard in the treatment of inguinal and femoral hernias. The operation is performed through a total of three small incisions at the navel and in the midline below it. The incisions are approx. 5-12 mm long and are usually barely visible a year after the operation. Another advantage of minimally invasive techniques is that both sides can be treated at the same time.
Total extraperitoneal hernioplasty (TEP): In this minimally invasive technique, the anatomical structures are dissected strictly outside the abdominal cavity in the layers of the abdominal wall. The hernia is released from the inguinal canal and the structures are returned to their anatomically correct position. A plastic mesh is then inserted to close the hernia gap.
Transabdominal preperitoneal hernioplasty (TAPP): In this procedure, the abdominal cavity is first entered in a minimally invasive manner. The peritoneum in the area of the hernia is then opened and the hernia is then returned to its correct anatomical position and the hernia gaps are then closed with a synthetic mesh. Finally, the initially opened peritoneum is closed again with sutures.
For some patients, however, minimally invasive techniques are not feasible or do not make sense. One example of this is significant previous abdominal surgery. In such cases, open procedures, which are performed via a groin incision, are a good and safe alternative.
Inguinal hernioplasty according to Lichtenstein: In the Lichtenstein technique, the inguinal region is accessed via an approx. 5-6 cm long incision in the groin region. The inguinal canal is then opened and the structures of the hernia are then returned to their correct anatomical position. The posterior wall of the inguinal canal, which has been weakened by the hernia, is then reinforced with a plastic mesh and the inguinal canal is closed again to complete the procedure.
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