For the past 10 years, whenever the bulging mass in his groin caused pain, Mr. Be would gently rub and push it back into his abdominal cavity. Recently, the mass grew larger, with more bowel protrusion, and the pain intensified, accompanied by tightness. An ultrasound at Tam Anh General Hospital TP HCM revealed a left inguinal hernia with a neck approximately 15 mm wide. The hernia sac contained a segment of the colon, measuring 52x37 mm, with visible blood flow in the bowel wall but surrounding fat infiltration. Doctor Nguyen Quoc Thai, Head of the Department of Gastrointestinal Surgery at the Center for Endoscopy and Endoscopic Gastrointestinal Surgery, diagnosed the patient with an incarcerated inguinal hernia, where the sigmoid colon had entered the hernia sac.

Following a consultation, doctors opted for laparoscopic surgery to implant an artificial mesh. This procedure aimed to reinforce the abdominal wall, return the trapped bowel segment to the abdominal cavity, and prevent future recurrence and incarceration.

This surgery presented significant challenges due to the patient's advanced age, thin abdominal wall, and extensive fibrotic tissues, according to Dr. Thai. Dissection carried a risk of injury to the bladder or bowel. Additionally, the patient faced a high risk of myocardial infarction and stroke during and after surgery due to the effects of anesthesia.

Dr. Thai (second from right) performs laparoscopic surgery to implant an artificial mesh for the patient. *Photo: Tam Anh General Hospital*

The surgical team performed minimally invasive laparoscopic surgery to minimize pain, limit complications, and shorten the patient's recovery time. They reduced the use of strong painkillers to prevent confusion and respiratory failure in the elderly. Surgical maneuvers were quick and precise to minimize anesthesia duration. The team fully dissected the hernia sac before placing an artificial mesh to cover the entire weakened groin area.

Post-surgery, Mr. Be recovered well. He experienced no pain, could walk within 24 hours, resumed normal eating, and was discharged shortly thereafter.

Mr. Be is assisted by a nurse with walking exercises after surgery to implant an artificial mesh, preventing hernia recurrence. *Photo: Tam Anh General Hospital*

Inguinal hernia is a common condition, affecting men more frequently than women. In its early stages, it can cause dull pain or discomfort in the groin, especially after prolonged standing, coughing, straining, or exertion. This can impact daily activities and reduce quality of life. Many individuals delay treatment, either due to complacency or apprehension about surgery, which increases the risk of complications.

The condition is linked to several factors, including age, gender, genetic predisposition, and prolonged increased abdominal pressure resulting from chronic cough or constipation.

To prevent inguinal hernias, Dr. Thai advises a diet rich in fiber, including plenty of vegetables and fruits, and adequate water intake to avoid constipation. He also recommends limiting alcohol and tobacco consumption and avoiding activities that increase abdominal pressure. If symptoms such as a groin bulge that enlarges with prolonged standing, coughing, or straining, or feelings of pain, burning, heaviness, fullness in the groin, or scrotal swelling in men appear, individuals should seek early examination and treatment at a specialized medical facility to prevent dangerous complications.

Quyen Phan