The name of femoral hernia also called crural comes from its seat: the femoral or crural ring. This is a space below the inguinal bend so it is in a lower position than the Inguinale hernia.
INDEX:
1. DESCRIPTION AND SYMPTOMS OF THE FEMORAL HERNIA
2. SURGICAL TECHNIQUES:
2.1. HERNIOPLASTIC WITH MESH FOR FEMORAL HERNIA WITH OPEN TECHNIQUE
2.1.1. POST-OPERATIONAL INFORMATION OPEN FEMORAL HERNIA
2.2. LAPAROSCOPIC HERNIOPLASTIC FOR FEMORAL HERNIA WITH MESH
2.2.1. FEMORAL HERNIA POST-OPERATING INFROMATIONS WITH MESH
1.FEMORAL HERNIA DESCRIPTION AND SYMPTOMS
The name of femoral hernia also called crural comes from its seat: the femoral or crural ring. This is a space below the inguinal bend so it is in a lower position than the Inguinale hernia. The space in which the hernia is inserted is very narrow and does not dilate easily. This is the reason why crustal hernia is much more commonly affected by inguinal hernia. Also in this restricted area must pass the artery, vein and femoral nerve. For this reason, patients with crural hernia often have pain that extends to the thigh and leg. It is therefore very important that in the case of a hernia crisis, a surgeon is promptly addressed to us, who after confirming the diagnosis will arrange for surgery. Diagnosis is sometimes made difficult by the presence of fat and also the ultrasound often from dubious results. It is not uncommon for chest-crusted hernia to be confused with inguinal lymph nodes. In case of doubt, however, it should work.
2. SURGICAL TECHNIQUES:
The type of treatment is similar to that for inguinal hernia (see), can be treated with a FEMORAL HERNIOPLASTIC WITH MESH with open technique or with LAPAROSCOPIC HERNIOPLASTIC WITH MESH.
2.1. HERNIOPLASTIC WITH MESH FOR FEMORAL HERNIA WITH OPEN TECHNIQUE
It is the most used technique for both its brilliant results and its ease of execution. One prerogative of this intervention is that it can, in most cases, be performed in LESTERN ANESTHESIS (ie with local anesthetic injections just above the groin).
Often the patient fears of these "bites" and the anesthetist helps with a slight sedation that avoids the subject from experiencing the surgical event as a trauma. Unlike inguinal hernia, a small horizontal engraving is performed at the level of the 4-5 cm groin, and the vein entrapped in the abdominal cavity is reintroduced. The next repair is currently carried out with a technique that contemplates the placement of a MESH of non-absorbable material (eg polypropylene) that induces a cicatrial reaction to create a barrier preventing further hernia formation. The mesh is wound on itself in the shape of a cone or "cigarette" that is threaded into the hernia and fixed with a point or glue.
The wound closure is performed with absorbable stitches (no visible spots on the skin) and waterproof trays. The intervention usually lasts 30 minutes After the intervention, the patient can go home accompanied but needs a series of instructions on post-operative phases, whose understanding is essential to prevent the operation from being "abandoned" by the surgeon . To this end, I have written a post-operative instruction sheet (I call it "Instructions for Use") that I give before discharge which usually takes place after 1-2 hours of intervention.
2.1.1. POST-OPERATING INFORMATION AFTER INTERVENTION OF HERNIOPLASTIC OF DOTT CARLO FARINA
The operated part remains generally painless for many hours after surgery thanks to the local anesthetic. If you get a sore throat, take the pain medication prescribed in the attached discharge letter. Tolerance and the threshold of pain vary considerably from patient to patient, so someone will need painkillers for 4-5 days, while nothing else. During the postoperative period the patient can do whatever he feels able to do.
We recommend the use of an ice bag for the first time on the affected region and also after swelling. Patients working with bilateral or inguinal-scrotum hernias will generally have more discomfort in the postoperative, especially during position changes, ie from sitting position and standing position, and vice versa. Once the desired position is taken, the pain will disappear.
The surgical incision is closed with intradermal or internal dots that resorb themselves (there are no visible spots on the skin) and is protected by some steristrips above which there is a gauze. The patient can shower after 3 days of surgery with all medication, having the sole responsibility of replacing the gauze only, leaving the steristrips to be removed during post-operative dressings.
It is advisable that the patient, from the day of the intervention and the next few days, travels, unless otherwise instructed by the surgeon, because the physical activity reduces and promotes a quicker disappearance of the pain. The mesh used for this operation makes the repair extremely strong and solid immediately.
Sports activities will be picked up gradually at the end of the first month of intervention. It will have to avoid too much food, drink at least two liters of liquid - non-gassed water, the juice, fruit juice, broth, etc. - for the first few days, in order to promote intestinal functions and avoid the efforts to evacuate. It may eventually take a mild laxative after the second day. (Eg: Laevolac: 1 bag in the evening)
It is recommended that you avoid driving the machine for 5 days. After the intervention, and in the following days, the patient could observe a number of possible situations:
Pain in the inguinal region, on the side and towards the genitals: of varying intensity and controllable with analgesics;
• Ecchymosis (blue-blackish coloration) on the skin of the pubic region, on the side, on the scrotum, on the genital organ: it tends to disappear in a couple of weeks;
• Swelling, sometimes very obvious, in the same regions: it regresses after 1 to 2 weeks (useful ice bag).
• Some drops of blood on medication;
• Mild burns, small bumps and lack of sensitivity may rarely occur. These effects will alleviate until disappearing within a few weeks.
• Sometimes resumption of motor activity may coincide with the appearance of inguinal pain, which attenuates and disappears in about 10 days. They are caused by network settling on the contraction muscle may also occur long after the intervention.
• Fever (without trembling and / or chills): It is the normal reaction of the body to stress.
In the affected inguinal region, within a week it will form a "sausage" hard form: this is due to the normal scar tissue reaction. It will tend to disappear completely within a few months. These events are absolutely normal and foreseen. Therefore, they should not cause any concern if they are present in the form described.
If some of these situations should be of considerable size (39 ° C fever with chills and / or tremors, intense and unbearable pain, abnormal swelling, free bleeding of the wound) the patient should promptly notify the surgical team.
For any further information or if necessary we are available at our contact details (possibly leave a message in the answering machine). For any further information or, if necessary, we are available at our contact details, provided that the first three days of intervention will be necessary
2.2. LAPAROSCOPIC HERNIOPLASTIC FOR FEMORAL HERNIA WITH MESH
I practice this technique mainly in cases of bilateral or recurrent inguinal hernias. The intervention is to repair the hernia defect with a net inserted in the inside of the defect rather than from the outside as in the traditional hinge. The repair is carried out laparoscopically by inserting the instruments and the net through three small holes of 0.5 cm, blowing gas into the abdomen.
The technique from a functional point of view has its rational: It's like fixing a hole in a tire: usually you place a "piece" outside the hole (traditional ernioplasty with mesh) but if we could place the "piece" Inside to close the hole the repair would be much more durable. The disadvantages compared to traditional technique are represented by the need for general anesthesia and longer operating times. So the comparison with the traditional technique is in favor of the latter for single hernias, while it is surely more beneficial to repair a bilateral hernia with three thumbs instead of two inguinal incisions of 4-5 cm. A separate discourse deserves the RELAPSE HERNIA repair. It is an intervention that requires some experience as the area to be repaired is rich in adherence especially if a network has previously been placed. Reincarnation externally is indeed very complex, while performing the intervention from the inside, laparoscopic allows it to work in a still virgin area.
2.2.1. OPERATING INFORMATION AFTER THE INTERVENTION OF LAPAROSCOPIC HERNIOPLASTIC OF DOTT CARLO FARINA
The operated part remains generally painless for many hours after surgery thanks to painkillers. We recommend the use of an ice bag for the first few hours on the affected region and also after swelling. Patients working with bilateral or inguinal-scrotum hernias will generally have more discomfort in the postoperative, especially during position changes, ie from sitting position and standing position, and vice versa. Once the desired position is taken, the pain will disappear.
Surgical engravings are closed with intradermal stitches that resurface themselves (there are no visible spots on the skin) and are protected by some white waterproof trays (steristrips) above which there is a gauze. You can take a shower after 3 days of surgery with all the dressing, taking care after the shower to replace only the gauze leaving the steristrips to be removed during post-operative dressings.
It is advisable that the patient, from the day of the intervention and the next few days, travels, unless otherwise instructed by the surgeon, because the physical activity reduces and promotes a quicker disappearance of the pain. The network used for this operation makes the repair extremely strong and solid immediately. Sports activities will be picked up gradually at the end of the first month of intervention.
For the first 15 days you will experience a feeling of abdominal swelling, which will eventually disappear. It will have to avoid too much food, drink at least two liters of liquid - non-gassed water, the juice, fruit juice, broth, etc. - for the first few days, in order to promote intestinal functions and avoid the efforts to evacuate. It may eventually take a mild laxative after the second day. (Eg: Laevolac: 1 bag in the evening) We recommend that you avoid driving the machine for 5 days.
After the intervention, and in the following days, the patient could observe a number of possible situations:
• Pain, of a modest extent at wound level, especially umbilical. They diminish intensity and disappear in about seven days. They are well controlled by painkillers (eg TORADOL 15-25 full stomach drops at the need).
• Vulnerable pain at right shoulder level. It is a reflection of diaphragm relaxation, typical of laparoscopic interventions. It will decrease until it disappears in 5-7 days. It compares to about 20% of cases and responds to painkillers.
• Ecchymosis (blue-blackish coloration) on the skin of the pubic region, on the side, on the scrotum, on the genital organ: it tends to disappear in a couple of weeks;
• Swelling, sometimes very obvious, in the same regions: it regresses after 1 to 2 weeks (useful ice bag).
• A few drops of blood on medication.
• Fever (up to 38 ° C without tremors or chills): It is the normal reaction of the body to stress, and disappears in about 7 days (possibly TACHIPIRINA 500 mg - 1 Cp).
• Mild burns, small bumps and lack of sensitivity may rarely occur. These effects will alleviate until disappearing within a few weeks.
• Sometimes the resumption of motor activity can coincide with the compar
