Laparoscopic Inguinal Hernia Surgery
Laparoscopic Inguinal Hernia Surgery
WHAT IS A HERNIA? A hernia occurs when the inside layers of the abdominal muscle have weakened, resulting in a bulge or tear. In the same way that an inner tube pushes through a damaged tire, the inner lining of the abdomen pushes through the weakened area of the abdominal wall to form a small balloon-like sac. This can allow a loop of intestine or abdominal tissue to push into the sac. The hernia can cause severe pain and other potentially serious problems that could require emergency surgery. Both men and women can get a hernia. You may be born with a hernia (congenital) or develop one over time. A hernia does not get better over time, nor will it go away by itself.
HOW DO I KNOW IF I HAVE A HERNIA? The common areas where hernias occur are in the groin (inguinal), belly button (umbilical), and the site of a previous operation (Incisional). It is usually easy to recognize a hernia. You may notice a bulge under the skin. You may feel pain when you lift heavy objects, cough, and strain during urination or bowel movements, or during prolonged standing or sitting.
WHAT CAUSES A HERNIA? The wall of the abdomen has natural areas of potential weakness. Hernias can develop at these or other areas due to heavy strain on the abdominal wall, aging, injury, an old incision or a weakness present from birth. Anyone can develop a hernia at any age. In adults, a natural weakness or strain from heavy lifting, persistent coughing, and difficulty with bowel movements or urination can cause the abdominal wall to weaken or separate.
TYPES OF HERNIA
WHAT ARE THE ADVANTAGES OF LAPAROSCOPIC HERNIA REPAIR? Laparoscopic Hernia Repair is a technique to fix tears in the abdominal wall (muscle) using small incisions, telescopes and a patch (mesh). If offers a quicker return to work and normal activities with a decreased pain for patients.
ARE YOU A CANDIDATE FOR LAPAROSCOPIC HERNIA REPAIR? Only after a thorough examination can your surgeon determine whether laparoscopic hernia repair is right for you.
WHAT PREPARATION IS REQUIRED? Preoperative preparation includes blood test, medical evaluation, chest x-ray and ECG.After your surgeon reviews with you the potential risks and benefits of the operation, you will need to provide written consent for surgery. It is recommended that you shower the night before or morning of the operation. After midnight, the night before the operation, you should not eat or drink anything except medications that your doctor has told you. Quit smoking and arrange for any help you may need at home.
HOW IS THE PROCEDURE PERFORMED? There are few options available for a patient who has a hernia. Most hernias require a surgical procedure. Surgical procedures are done in one of two fashions. The open approach is done from the outside through a three to four inch incision in the groin or the area of the hernia. The incision will extend through the skin, subcutaneous fat, and allow the surgeon to get to the level of the defect. A small piece of surgical mesh is used to repair the defect or hole. This technique is usually done with a local anesthetic and sedation but may be performed using a spinal or general anesthetic.
The laparoscopic hernia repair: In this approach, a laparoscope (a tiny telescope) connected to a special camera is inserted through a cannula, a small hollow tube, allowing the surgeon to view the hernia and surrounding tissue on a video screen. Other cannulas are inserted which allow your surgeon to work “inside.” Three or four quarter inch incisions are usually necessary. The hernia is repaired from behind the abdominal wall. A small piece of surgical mesh is placed over the hernia defect and held in place with small surgical staples. This operation is usually performed with general anesthesia.
WHAT HAPPENS IF THE OPERATION CANNOT BE PERFORMED OR COMPLETED BY THE LAPAROSCOPIC METHOD? In a small number of patients the laparoscopic method cannot be performed. Factors that may increase the possibility of choosing or converting to the “open” procedure may include obesity, a history of prior abdominal surgery causing dense scar tissue, inability to visualize organs .The decision to perform the open procedure is a judgment decision made by your surgeon either before or during the actual operation. The decision to convert to an open procedure is strictly based on patient safety.
WHAT SHOULD I EXPECT AFTER SURGERY? With any hernia operation, you can expect some soreness mostly during the first 24 to 48 hours. You are encouraged to be up and about the day after surgery. With laparoscopic hernia repair, you will probably be able to get back to your normal activities within a short amount of time. Call and schedule a follow-up appointment within 2 weeks after you operation.
WHAT COMPLICATIONS CAN OCCUR? Any operation may be associated with complications. The primary complications of any operation are bleeding and infection, which are uncommon with laparoscopic hernia repair. Difficulty urinating after surgery is not unusual and may require a temporary tube into the urinary bladder for as long as one week. Any time a hernia is repaired it can come back. This long-term recurrence rate is not yet known. Your surgeon will help you decide if the risks of laparoscopic hernia repair are less than the risks of leaving the condition untreated.
WHEN TO CALL YOUR DOCTOR Be sure to call your physician or surgeon if you develop any of the following: persistent fever over 100 degrees F, bleeding, increasing abdominal swelling, pain that is not relieved by your medications, persistent nausea or vomiting, chills, persistent cough or shortness of breath, purulent drainage (pus) from any incision, redness surrounding any of your incisions that is worsening or getting bigger.