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Dr. Andrew Rynne

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How can a hernia that has slipped into the scrotum be treated?

Answered by
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Dr. Manjunath Metri

General Surgeon

Practicing since :2005

Answered : 383 Questions

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Posted on Mon, 23 Apr 2018 in Lump
Question: For hernia repair surgeon. I have large hernia that recently became worse and has slipped into my scrotum and must be done with the old fashion open approach . There and many ways to do it . Ucla uses Lichtenstein local approach , the Ethicon butterfly mesh is another approach . In the UK Drscardis center is advocating a tension free approach and has opened a center in USA. I did have a left inguinsl hernia repair with mesh 30 years ago. I think my current hernia may be a tear in the old one but no one has definite said. XXXXXXX
doctor
Answered by Dr. Manjunath Metri 8 hours later
Brief Answer:
I would go for Lichtenstein Mesh Hernioplasty

Detailed Answer:
Hi and welcome to HealthcareMagic..
I thank you for posting your query here and I am definitely going to help you out..

I read your question completely and have understood it well enough..

Please note..

1. No, the old one was on the left side right where you have got your repair done.
And now it's on the right?

Yes this happens, considering your age..
Do not worry. There's no tear or something.

Unless you don't have recurrence on the previous operated side, it is all fine..

2. I do some 100s of hernia surgeries in each month and I can assure you that, definitely its a clean surgery.
With good expertise, results are great.

3. Personally, I prefer the open Lichtenstein Tension free Mesh Hernioplasty.
It's mentioned as Procedure of choice in various articles published.

4. But definitely it goes with the hospital protocol also..

5. Any of these will do. But since the hernia is already reached the scrotum, better to get operated as early as possible.

Hope this helps you.
In case you need further assistance, please contact me back..
Or you can close the question and rate..
Take care and all the best..
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Manjunath Metri 2 hours later
Thank you Dr, but clarify my question . The current hernia is on left of scrotum where the old Hernia was when repaired 20+ years ago with mesh by a progressive surgeon. This clarification may mean a revised response. I don’t know much about the Lichtenstein approach and can investigate and call them but I don’t know ifsny of thmesh is internal or only on iutdidey. So far no surgeon has asked for any imaging studies. Some say the buttetfly mesh approach can protect internal organs. Can you comment on this and issues related to the fact the current hernia and old repaired hernia
doctor
Answered by Dr. Manjunath Metri 1 hour later
Brief Answer:
Yes Hernias are known to recur post operatively

Detailed Answer:
Hi and welcome back...

Please note..

1. So this is recurrent hernia not the new one.
Yes it happens, hernias are known to recur even after done by an expert surgeon.

Lichtenstein repair is a tension free repair, and use of mesh to strengthen the hernial defect.

2. And don't worry about internal organs being protected, hernia repair in open approach, no internal organs are touched.

3. And yes. Hernia is a clinical diagnosis, not investigation based. Hence no surgeons has asked for investigation.

Hope this helps you..
In case you need further assistance, please contact me back.
Or you can close the question and rate..
Take care
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Manjunath Metri 3 hours later
Very helpful at a difficult time of year in XXXXXXX to get the hernia repaired ASAP. Would you consider surgery group that specialized only in hernia surgery would provide an advantage over a general surgeon?
doctor
Answered by Dr. Manjunath Metri 7 minutes later
Brief Answer:
Definitely..

Detailed Answer:
Thanks for getting back...

Please note...

1. See definitely there will be advantage where they do lot of cases particular to hernia.

But then even surgeon should also be good.

2. Decide and get your surgery done by a good hernia surgeon, general or specialist should not matter..

Hope this helps you..
In case you need further assistance, please contact me back.
Or you can close the question and rate.
Take care..
Above answer was peer-reviewed by : Dr. Nagamani Ng
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