It is usually recognized as one swelling in the groin, i.e. in the area where the torso passes to the thigh. At this point there is a hollow formation, the inguinal canal, which is a smooth point of the abdominal wall. Therefore, if any intra-abdominal viscera, usually the intestine, protrudes outside the abdominal wall through the inguinal canal, an inguinal hernia is caused. This projection manifests itself as a swelling under the skin and in the initial stages it can be asymptomatic.

How is an inguinal hernia created?

In cases of weakening of the abdominal wall in combination with the presence of increased intra-abdominal pressurethe congenitally weakest point of the inguinal canal can be a way of projection of some intra-abdominal splanchnic to the outside and in this way the inguinal hernia is created. The main factors that contribute to the appearance of a hernia in the inguinal region are:

• Vigorous exercise, especially weight lifting
• The increase in intra-abdominal pressure during pregnancy
• Genetic predisposition
• Obesity
• Heavy manual work
• Chronic cough / smoking
• Severe constipation

What symptoms are associated with an inguinal hernia?

“Initially, an inguinal hernia can be hidden, that is, despite its presence, it does not cause symptoms to the patient. The main characteristic of the inguinal hernia, which usually mobilizes the sufferer, is the characteristic bulge in the groin area. Other symptoms that may indicate the presence of an inguinal hernia are:

• Swelling that does not redistribute
• Pain especially when coughing or constipation
• Sensation of burning or electricity in the area
• Difficulty urinating or defecating

The symptoms caused by the inguinal hernia should not be ignored, while the non-definitive treatment of the condition can lead to the appearance of complications. The most common complication of an inguinal hernia is stricture, in which the intra-abdominal viscera that protrudes into the hernia becomes firmly trapped outside the abdominal wall. This fact can even lead to ischemia or even necrosis of the splenium. Therefore, stricture is a medical emergency that is treated immediately surgically,” points out dr Charalambos Spyropoulos MD, PHD, FACS General Surgeon, Master Surgeon in the Surgical Treatment of Abdominal Wall Hernias (SRC accredited), Director of Surgical Clinic III & Center of Excellence for Abdominal Hernia Surgery at Metropolitan General, Certified Robotic Surgeon (Center of Excellence in Robotic Surgery, Misericordia Hospital, Grosseto, Italy) and continues:

How can an inguinal hernia be treated?

“An inguinal hernia can only be definitively treated with surgical intervention. Modern treatment includes almost exclusively the application of minimally invasive methods, as they are associated with minimal post-operative pain, rapid recovery and immediate return to the patient’s daily life.

OR Endoscopic TEP method is the one minimally invasive technique performed through 3 small incisions. The operation is completed with the laparoscope (special camera) and the laparoscopic tools, not inside the abdomen, but inside the patient’s muscle wall. In this way, the hernia repair is carried out completely extra-abdominally, without the need to cut muscles and suture the peritoneum, avoiding any contact with the visceral environment of the abdomen.

The Robotic surgical approach is the most modern option in the treatment of hernias of the abdominal wall. The Da Vinci Chi robotic system is an advanced robotic platform and a unique surgical tool in the hands of the experienced robotic surgeon. Through special controls on the central console of the system that reproduce the surgical manipulations on the special robotic arms, the surgeon performs the operation with exceptional fluency and range of motion, With the help of the built-in high-resolution 3D camera, he can perform the hernia repair in absolute detail and to place the surgical mesh at an ideal point, avoiding injuries to the surrounding tissues and unnecessary surgical trauma to the abdominal wall. Hospitalization almost always lasts a few hours and the patient’s recovery is very fast”, concludes Dr Spyropouloss.