Treating inguinal hernias (inguinal hernia operation), hernia therapy

This method was introduced in 2002 by Dr. Ulrike Muschaweck and has since gained global acceptance for the surgical repair of sports hernias.
It can also be applied for small inguinal hernias. The principle behind it involves making no incisions into intact structures and instead only "repairing" the actual defect. A tension-free suturing technique means that pain after the operation is significantly less, and the muscles required for unrestricted movement remain fully intact. With this method, patients can return to sport after just 2-3 days without any increased risk of a further inguinal hernia.

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In patients whose indirect and direct hernias do not exceed a certain size, the Canadian method developed by Dr. E. Shouldice (tailored surgery) is used.
The hernial orifice is closed using a fascia displacement technique, which is a type of suturing technique. The key point here is that the posterior wall of the inguinal canal needed for the suturing technique required for the suturing technique is sufficiently strong to allow the suturing procedure to take place.

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In patients with a medial hernia in which a classic suturing method does not appear to be sufficient, this more recent method developed by the Indian surgeon Mohan P. Desarda, which uses the body's own tissue (the lower section of the external fascia) to reinforce the posterior wall, can be used. If the fascia displacement flap has the right physical characteristics, this technique can achieve similar results to surgery without the use of synthetic meshes.

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In patients with a weak abdominal wall and large hernial orifices (direct hernias, direct inguinal hernia), the Lichtenstein method can be used. This is a tension-free method involving the implantation of a mesh. This surgical method has also been proven to be effective for recurrent hernias (repeat herniation). This procedure, first described by Irving Lichtenstein, was introduced in 1985 and is the world's most commonly performed open mesh procedure.

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This method is based on the surgical technique developed by Dr. Rives. In this case, a large mesh is positioned below the abdominal wall fascia between the abdominal wall and the peritoneum (pre-peritoneal). This procedure is suitable for patients with complex hernias, combined hernias and recurrent hernias.

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In view of the specific problems that are associated with them (general anaesthesia, possibility of serious complications, inevitable mesh implantation, inpatient admission), laparoscopic methods are reserved exclusively for special cases (such as multiple recurrences) and are subject to strict indication criteria.

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