Inguinal hernia is a common condition encountered by any surgeon. It is a protrusion of abdominal contents through an opening in the groin otherwise called as the Myopectineal orfice. It has a very elaborate anatomy, the understanding of which has been made very clear due to Robotic vision of the area. Right from the embryological intra-abdominal presence of the testis to the descent into the scrotum, the various tissue planes have been identified and this has helped in precise dissection of the area with very good results.
Though occasionally seen in women it is more common in men. Diagnosis is mostly by clinical examination and if required by ultrasound of the abdomen. There could be precipitating factors like difficulty in passing urine , stool or chronic cough. These have to be treated too. Complications like strangulation of intestines require emergency surgery.
The treatment for Inguinal hernia has always been surgery. Initially it was open surgery by a groin incision. Since 1996 I have been performing Laparoscopic Inguinal hernia repairs. After performing thousands of lap repairs the advantages of Robotics has made me go through the whole learning process again. The 3D vision with 10times magnification displays the anatomy clearly allowing me to dissect all 3 zones properly following the ten steps of Inguinal hernia repair. There is no need to use tackers to fix the mesh as it is sutured. This reduces the pain very much with early return to work. Use of anatomical meshes with minimum size of 15x10cms has standerdised the repair with few recurrences. Large inguinoscrotal hernia’s sometimes do require open surgery as also complicated hernia’s