Inguinal hernia (inguinal hernia): Causes, symptoms and modern treatment with the TAPP method

An untreated inguinal hernia can lead to serious complications, such as Incarceration of parts of the intestine. Therefore, early diagnosis and therapy are crucial. In the Hernia Center Berlin At VenaZiel we offerthe latest minimally invasive treatments, in particular the TAPP method.

Anatomy of the groin region: Why does a hernia occur?

The groin is a natural weak point in the abdominal wall. In men, the spermatic cord, and in women, the round ligament, exits the abdominal cavity there. Tissue can protrude outwards through this anatomical canal, the inguinal canal (Canalis inguinalis). This happens when the wall becomes weaker.

Forms of inguinal hernia

Indirect break

• • Runs along the inguinal canal
  • Mostly congenital or occurs in young men

Direct break

• • Penetrates directly through the posterior abdominal wall
  • Common in older men

Femoral hernia

• • Runs below the inguinal ligament
  • Occurs more frequently in women

Note: A hernia can be unilateral or bilateral occur.

Causes and risk factors

An inguinal hernia occurs when the pressure in the abdominal cavity is higher than the stability of the abdominal wall – e.g. due to:

• Congenital connective tissue weakness
• Chronic cough, asthma, COPD
• Heavy lifting or carrying
• Constipation with heavy pressing
• Overweight
• Previous operations
• Pregnancy (less common in women)

Symptoms of a hernia

Not every hernia causes pain immediately – but there are typical signs:

• Visible or palpable protrusion in the groin area
• Pulling or burning sensation when coughing, lifting or pressing
• Pain during physical activity
• Feeling of pressure or foreign body sensation
• In men: swelling up to the scrotum

In the event of complications such as Incarceration symptoms can suddenly increase dramatically:

• Severe pain
• Redness and hardening
• Nausea, vomiting, fever
• It is no longer possible to push back the protrusion → Emergency!

Diagnostics

Our experienced specialists carry out a thorough examination:

1. Medical history: Complaints, stress, family history
2. Physical examination: Standing and lying down, coughing maneuver
3. Ultrasound: Reliable detection of the fracture sac, fracture contents and dynamics
4. MRI / CT: For complex or multiple operated patients

Treatment options – When should surgery be performed?

A hernia does not heal on its own. The only sustainable solution is surgery – ideally minimally invasive.

Indication for surgery:

• Discomfort (pain, feeling of pressure)
• Increasing fracture size
• Double-sided fracture
• Risk of entrapment
• Restrictions in work or sport

TAPP: The modern, gentle surgical technique

The TAPP method is a minimally invasive technique. It is also known as the “keyhole” technique. This method is one of the best for treating inguinal hernias worldwide.

Advantages of the TAPP method:

• Minimally invasive: Small incisions and minimal tissue trauma
• Less pain: Less pain intensity after the operation
• Rapid recovery: Return to everyday life often after just a few days
• Double-sided hernias can be treated: Both groins can be treated in a single operation
• Mesh implant from the inside: Provides a comprehensive and stable reinforcement of the abdominal wall
• Very low recurrence rate: Recurrence rate is less than 1-2 % for experienced surgeons

Procedure of the TAPP-OP:

1. 3 small incisions in the abdominal wall
2. Inserting a camera & surgical instruments
3. Visualization of the inguinal canal & re-displacement of the hernia sac
4. Insertion of a special plastic mesh (usually 10×15 cm)
5. Closure of the peritoneum & skin sutures

Other surgical methods in comparison

TAPP (transabdominal preperitoneal plasty)

• • Technique: Laparoscopic
  • Advantage: Gentle method, treatment on both sides possible, fast recovery
  • Disadvantage: Requires a lot of operational experience

TEP (total extraperitoneal plasty)

• • Technique: Laparoscopic
  • Advantage: No entry into the abdominal cavity
  • Disadvantage: Technically complex with previous operations in the groin area

Lichtenstein method

• • Technique: Open surgery with mesh
  • Advantage: Proven standard, especially for older patients
  • Disadvantage: Larger wound, more frequent pain after the operation

Shouldice method

• • Technique: Open surgery without mesh
  • Advantage: Suitable for young patients with a small fracture
  • Disadvantage: Higher risk of recurrence of the fracture (recurrence)

After the operation: What should patients bear in mind?

• Stay: outpatient or 1 night inpatient
• Movement: immediately possible, early mobilization recommended
• Pain: minor, treatable with mild painkillers
• Sport/exercise: after 2-3 weeks light activity, after 4-6 weeks sport
• Follow-up appointment: after 7-10 days in the hernia center

Risks of an untreated hernia

An unoperated hernia harbors long-term risks:

• Intestinal incarceration
• Death of tissue (necrosis)
• Intestinal obstruction
• Chronic groin pain
• Reduced quality of life

Conclusion: Your center for hernia surgery in Berlin

The hernia is a common but very treatable condition. With the TAPP method is a modern, safe and particularly gentle surgical technique.

At the Hernia Center Berlin at VenaZiel you benefit from:

• Specialization in hernia surgery
• Minimally invasive techniques such as TAPP and TEP
• Modern operating theaters & certified implants
• Personal support & fast appointment allocation

Make an appointment now at our hernia center
Our specialized specialists will advise you personally and work with you to find the optimal treatment strategy.

Give us a call or book your appointment directly online!

FAQ: Frequently asked questions

1. what exactly is a hernia?

An inguinal hernia is a condition where tissue, such as fat or parts of the intestine, protrudes from the abdominal wall through a weak spot in the groin area. This results in a palpable bulge, often accompanied by pulling sensations or pain.

2. can a hernia disappear by itself?

No. An inguinal hernia does not resolve on its own and may become larger or incarcerated over time. Surgery is the only permanent solution.

3. how can I tell if my hernia is dangerous?

Warning signs are:

• Suddenly severe pain,
• swelling that can no longer be pushed back,
• Nausea, vomiting or fever.

This may indicate an incarceration – an emergency!

4 What surgical techniques are available?

We offer many common procedures. The modern TAPP method, in particular, is minimally invasive. We also perform the open Lichtenstein operation and the TEP technique. We will determine the ideal method for you in a personal consultation.

5 Why do you recommend the TAPP method so often?

The TAPP technique offers a gentle and safe treatment. It is fast, even with bilateral fractures or after operations. The pain is minimal and the downtime is short.

6. will the health insurance company cover the surgery costs?

Yes, all procedures performed by us are covered by statutory health insurance. We discuss additional requests (e.g., special mesh material or private rooms) individually.

7 How long will I be off work after the operation?

After TAPP you are usually 3-5 days (for office work) – after approximately 2–4 weeks for physical work. Sport is usually possible again after 4–6 weeks.

8. is the operation also possible on an outpatient basis?

Yes – many hernia operations can be performed on an outpatient basis, provided there are no accompanying illnesses.

9. Do I have to wear a mesh? Is that safe?

Yes – in adults, a fine-meshed, biocompatible synthetic mesh is usually used, which remains permanently in the body. It stabilizes the abdominal wall and prevents relapses. The safety has been scientifically proven.

10. what happens if I do not have the hernia operated on?

If left untreated, it can lead to incarceration of the intestine – with the threat of bowel obstruction or even life-threatening conditions. Chronic pain or limitations in everyday life can also occur.