Inguinal hernia repair
Inguinal hernia repair can be done either laparoscopically or by the open approach.
The laparoscopic approach does have a quicker recovery rate. The surgeon will make three or four small incisions in which to insert laparoscopes. The laparoscopes will be attached to the equipment needed to perform the surgery. The surgeon can view the surgery by monitors. The hernia is repaired from behind the abdominal wall. A piece of surgical mesh is placed over the hole in the muscle that caused the hernia. The mesh is held in place by several small staples.
If the surgery cannot be performed laparoscopically, it will be done in a open approach. The surgeon will make a 3 to 4 inch incision in the groin area and then proceed to repair the defect, sometimes using surgical mesh. The incision will then be closed up using either sutures or surgical staples.
Specific medical and surgical complications for a inguinal hernia repair include, but is not limited to: infection, bleeding, nerve injury, chronic pain, blood clots, heart attack, allergic reactions, and pneumonia. These risks can be serious and possibly fatal. The significant risks of this procedure were discussed with emphases on: Recurrent hernia, urinary tract or bowel injury, vascular injury, testicular pain (males only), testicular swelling (males only), numbness, prosthetic mesh related complications, urinary retention, and cosmetic deformity.
Before your surgery, you will be required to have a pre admission testing appointment. At this appointment, you will be registered at the hospital; you will have lab work done and possibly a x-ray. You will also meet with an anestheologist.
No food starting midnight the night before surgery. Solid food must be avoided the day of surgery-regardless of the surgery time. Clear liquids must be stopped four (4) hours before your surgery.
Clear liquids are considered: water, apple juice, cranberry juice, black coffee (no cream), tea, and soda (7-UP, pepsi, ect).
You will be allowed to leave the hospital the same day as the procedure. You should expect some swollenness and soreness for the next 24 to 48 hours and it is a good idea to have a ice bag on hand.
Inguinal Hernia Repair Post-Surgery Guide
The following information is intended to guide you through your post-op recovery:
For the first few days after your return home you should eat foods that you easily tolerate normally
Follow the directions on any new prescriptions that your doctor has given you. You may return to taking your regularly scheduled medications on the day of your surgery, unless your doctor has directed you otherwise.
Pain management is an important part of your post-surgery care. You should expect some discomfort after your surgery. You may be sent home with a prescription for pain medication. It is important to take your pain medicine prior to your pain becoming intense in severity.
No pain medication refills will be authorized on the weekends. If a refill is needed, the request must be made before 12:00 noon on Friday.
Some side effects from the pain medications include nausea and constipation. If you experience nausea or vomiting related to your pain medications, you should stop the medication and take ibuprofen or acetaminophen for pain management.
To prevent constipation you should drink plenty of fluids and take a stool softener daily.
If you have not had a bowel movement within 48 hours after your return home, you should increase your fluid intake. You may take one single dose of Milk of Magnesia, as long as you have no abdominal distention.
You should apply ice packs to the area just above your groin (in the area of the repair) for the first 24-36 hours after your surgery. Apply the ice pack for 20-30 minutes every 1-2 hours while you are awake.
Please leave your dressings on for 48 hours (Dr.Stanton prefers you leave the dressing in place for 4 days, and you may shower with it in place) after your surgery. Unless your doctor specified otherwise you may then remove your dressing and shower. Remove the outer dressing and leave the strips of tape that cover your incision.
If your dressing becomes soiled, or loosens and comes off, you may replace it with a dry sterile dressing and tape.
You will have steri-strips of tape across your incision. Those strips should remain in place for 5-14 days. The strips will gradually loosen and come off. If they do not come off within 2 weeks you may remove them yourself.
You must observe your incision daily for signs or symptoms of infection. These signs would include: increased swelling, redness or smelly wound drainage. It is normal to have some swelling and bruising around your incision.
Physical Activity / Exercise
Minimize your activity level for the first 24 hours. Going to the bathroom is enough activity the first day.
Bathing and Showering:
You may shower after you remove your dressing which will be 48 hours post-surgery. You may shower with your steri-strips in place. Do not scrub across your steri-strips. Do not bathe in a tub for 10 days after your surgery. This includes a “hot tub”.
If you need to shave please be careful around your incision, and avoid shaving over the incision or any sutures in the area.
You may drive when you no longer are taking narcotic pain medications and you feel you can quickly respond to situations that will not place others in jeopardy.
Return to Work:
As a general guideline the following will give you a guide for when to return to work:
Light lifting or no lifting type jobs: You may return to work from a few days to one week post-surgery.
Heavy lifting or physical type jobs: You may return to work one week after surgery, with a weight/lifting restriction of no greater than 10-20# for 2 weeks total. If your job does not allow for light duty, then you will need to be off of work for 2 weeks after your surgery.
Increase your lifting weight gradually as your doctor recommends.
You will need to return to the office for a follow-up visit usually within 2 weeks after your surgery. Please make sure you have your appointment scheduled.
Some men may develop bruising in their penis and scrotum 24-72 hours after their surgery. If this occurs, the bruising usually takes a couple of weeks to resolve. This does not have any effect on the function of the penis or scrotum.
Problems to Observe For:
Call the office for the following:
1. Fever >101.0
2. Uncontrolled pain. That is on a scale of 1-10 (10 being the worst pain imaginable) your pain is a level 7 or above.
3. Nausea and / or vomiting that continue for 12-24 hours.
4. Diarrhea that continues for 12-24 hours.
5. Signs of a wound infection.
6. Chest pain or difficulty breathing
7. Your incision separates or opens up.
If you have further questions after reading this handout, the office is open from 9:00AM to 5:00PM Monday through Friday. For emergencies after office hours, the answering service will be available when you call the office number.
Northwest Surgical Specialists, LLP
American College of Surgeons www.facs.org
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