What is the inguinal hernia that Enzo Fernández suffers from and how long will his recovery take?

The NIH highlights the existence of different applicable surgical methods, including open surgery and laparoscopic surgery for hernias.

Enzo Fernández, key player of the Argentine team with a view to the next Copa América and midfielder for Chelsea, of the English Premier League, faces a challenge beyond the field: an inguinal hernia that has been affecting him since last year.

This condition can cause severe discomfort and interfere with intense physical activity, such as that required in professional football. The 23-year-old athlete decided to undergo surgery to address this problem at its roots and ensure his optimal physical condition for the continental tournament next June.

Inguinal hernia is a common but serious condition that affects a large number of people around the world, including high-performance athletes like Fernández. As described by Dr. Héctor Guillermo Olaya Rodríguez, General Surgeon in Neiva, Colombia, in a medical article in Top Doctors, “the inguinal hernia is one of the most common defects of the abdominal wall, which, as its name says, appears in the groin region.”

As described on its website, the United States National Institutes of Health (NIH) points out that “they are relatively common. Researchers estimate that about 27 percent of men and 3 percent of women will develop an inguinal hernia at some point in their lives.”

The inguinal hernia operation that Enzo Fernández undergoes is a common procedure but crucial for his career and physical well-being REUTERS/David Klein

Likewise, it points out that “an inguinal hernia is a bulging of the contents of the abdomen through a weak point in the lower part of the abdominal wall. Inguinal hernias can appear in any of the tubes in the lower part of the abdominal wall, one on each side of the groin. These canals are known as inguinal canals. Inguinal hernias can also occur through two deeper passages in the groin, known as the femoral canals. Hernias through these ducts are also known as femoral hernias.”

The Colombian expert explained that “the appearance of inguinal hernia has several causes, the most common is acquired, that is, over the course of life the abdominal wall at the inguinal level weakens and creates this defect. Nowadays there is talk of an important genetic role.”

“When an inguinal hernia occurs, part of the peritoneum (the lining of the abdominal cavity) protrudes through the abdominal wall and forms a sac around the hernia,” the NIH describes.

Regular or repeated activities cause increased pressure within the abdomen, such as lifting heavy objects and standing. This is one of the things that causes an inguinal hernia.

According to the NIH, “a lump in the groin, that is, the area between the lower abdomen and thighs, in men, a lump in the scrotum, a feeling of discomfort, pain, heaviness, or burning in the the groin”.

Dr. Olaya Rodríguez added that the symptoms “usually worsen with exercise and cough” and “can worsen when the person strains, lifts weight, coughs or stands for a long time and can improve when they rest or lie down.” The specialist recommended “carrying out a specialized assessment, since there are many causes of pain in the inguinal area.”

These factors include, according to NIH:

• Weaker than normal connective tissue or connective tissue disorders
• Genes that increase the risk of inguinal hernias
• Health conditions that cause increased pressure inside the abdomen, such as chronic cough or chronic constipation
• Regular or repeated activities that cause increased pressure inside the abdomen, such as lifting heavy objects and standing or walking for many hours every day at work.

Specialists indicate consulting with the surgeon “before restarting sports activities or other high-impact activities”

Surgeon Olaya Rodríguez pointed out that “the treatment of Inguinal Hernia in symptomatic patients is surgery, which consists of correction of the defect, generally using meshes.” On the other hand, in “asymptomatic patients with small defects they should also be followed regularly as expectant therapy with specialized follow-up.”

The NIH points out that there are several types of surgeries that can be performed. In general terms, it involves open and laparoscopic hernia surgery. “The type of surgery the doctor recommends may depend on factors such as the size of the hernia and the age, health and medical history of the patient,” he stressed.

Open hernia surgery involves making a cut in the groin to see and repair the hernia. After repairing the hernia, surgeons often use stitches and a piece of mesh to close the abdominal wall, as this device strengthens the weak point where the hernia occurred. In some cases, surgeons can use only sutures to close and strengthen the weak point in the abdominal wall, explains the US organization’s medical information site.

Surgery to repair an inguinal hernia is quite safe, according to experts (Gettyimages)

Anesthesia for most patients is usually local, but in the case of open hernia surgery a sedative is used. “In some cases, doctors may give patients general anesthesia or a spinal block to numb the body from the waist down,” the same source indicated.

In laparoscopic hernia surgery, “the surgeon makes several small cuts in the lower abdomen and inserts special tools to view and repair the hernia. The surgeon uses a piece of mesh to close and strengthen the abdominal wall,” the NIH said. Patients usually receive general anesthesia for laparoscopic hernia surgery.

Recovery time after laparoscopic surgery may be shorter than after open hernia surgery, according to NIH.

As highlighted by the experts at Medline Plus, the website of the United States Library of Medicine, “it is recommended to keep moving and walk on the day of surgery.” The recommendation is to gradually return to normal activities such as walking, driving and sexual activity, “when you feel ready.”

The medical team that assists Enzo Fernández in his inguinal hernia surgery is working to ensure his speedy recovery and return to the field REUTERS/Pedro Nunes

The advice includes avoiding lifting weights beyond 4.5 kilos for 4 to 6 weeks or until the doctor authorizes it. “If possible, avoid any activity that causes pain or pulls on the surgery area. “Older youth and adults may need athletic support if they experience testicular swelling or pain.”

The specialists indicate that you should consult with the surgeon “before restarting sports activities or other high-impact activities”, although they indicate that it is best to “avoid all sports that involve physical contact for at least three weeks”, since a blow where the injury occurred incision can open the wound. “Full recovery is expected within 2 to 4 weeks.” Likewise, the incision area should be protected from the sun for 1 year to avoid noticeable scarring.

Surgery to repair an inguinal hernia is quite safe. However, possible complications that may include urinary retention, infection, inflammation in the surgery area due to a buildup of blood, known as a hematoma, or a buildup of blood plasma, known as a seroma, chronic or severe pain, recurrence of the hernia, which could require further surgery, the NIH said.