The PolySoft hernia patch used with the ONSTEP technique to treat inguinal hernias

Introduction

An inguinal hernia is a protrusion of an internal part of the body through a weakness in the abdominal wall in the groin. Inguinal hernias can be split into two types: indirect and direct. An indirect inguinal hernia is formed from a hernia sac slipping through the internal inguinal ring. A direct hernia is formed by a bulge through the floor of the inguinal canal (Jenkins and O'Dwyer, 2008).

Inguinal hernias are the most common type of hernia, accounting for around 75% of abdominal wall hernias. They are more common in men than women, occurring in approximately 1 in 4 men and 3 in 100 women. Risk factors include age, obesity, heavy lifting, a long‑term cough and long‑term constipation (NHS Choices 2012).

Inguinal hernias can cause a soft swelling in the groin area, which will disappear if pressed. This may be associated with discomfort, which often increases with activity. They are not usually associated with pain. If part of the bowel protrudes and gets stuck, strangulation or obstruction can occur which requires emergency repair (Jenkins and O'Dwyer, 2008).

Inguinal hernias can be repaired surgically to reduce symptoms and prevent serious complications, using a technique that minimises the risk of recurrence. There is a wide variety of suitable repair techniques and products which are currently in use in the NHS. Bruising and haematoma are potential early complications of hernia surgery. Late complications include hernia recurrence, chronic pain and infertility (Jenkins and O'Dwyer, 2008).