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Femoral Hernia Repair

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A femoral hernia occurs when the abdominal organs begin to pass through a weakness by the inguinal ligament called the femoral canal. Although this is an uncommon type of hernia, occurring in about 3% of all hernia cases, it should not be underestimated due to the naturally weak nature of the femoral canal.

Additionally, femoral hernias occur predominantly in women due to the angle at which their femur meets their pelvis.

Types of Femoral Hernia

Femoral hernias can be divided into several sub-types in order of severity, including:

  • Reducible: these are minimally painful and may be fixed with moderate manipulation
  • Irreducible: if the protrusion becomes lodged in the opening, it will be more painful and require surgical manipulation to correct
  • Obstructive: intestinal tissue may become stuck in the hernia in such a way that it blocks passage of chyme, causing obstruction, which can become incredibly painful and force vomiting
  • Strangulated: the herniated area may become so tight that it may cut off the blood flow to the protrusion, causing extreme pain, nausea and vomiting; this is a medical emergency and must be treated immediately

Diagnosis of Femoral Hernia

Diagnosis is based primarily on physical examination, with the exception of overly obese patients who may need an X-Ray, CT scan or MRI to confirm. There are several other disorders that share many of the same symptoms and issues as femoral hernias that must be considered and ruled out before any treatment is attempted. Some of these similar disorders are: an abscess of the psoas, femoral artery aneurysm, saphena varix, inguinal hernia or swollen inguinal lymph node.

Treatment for Femoral Hernia

The hernia is only treatable through surgical manipulation, unless it happens to be a reducible type, which is fixed easily. The surgery may be performed in either a minimally invasive manner or as full open surgery, though both require general anesthesia. The surgeon first repositions the contents of the “hernia sac” to the correct places within the abdomen, and then attempts to repair the weakness in the muscle which allowed the herniation.

This may entail a set of sutures to hold it closed until natural healing takes place or a plastic mesh to cover the opening permanently. The use of a mesh graft is standard procedure in most serious cases, but it may be avoided if the patient has a history of rejecting implants.