Laparoscopic Inguinal Hernia Repair
What Preparation is Required?
- Most hernia operations are performed on an outpatient basis, and therefore you will probably go home on the same day that the operation is performed.
- Preoperative preparation includes blood work, medical evaluation, and an EKG depending on your age and medical condition.
- 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 with an antibiotic soap.
- After midnight the night before the operation, you should not eat or drink anything except medications that your surgeon has told you are permissible to take with a sip of water the morning of surgery.
- Drugs such as aspirin, blood thinners, anti-inflammatory medications (arthritis medications) and Vitamin E may need to be stopped temporarily for several days to a week prior to surgery. Your surgeon will discuss this with you and provide instructions regarding your medications around the time of surgery.
- Diet medication or St. John’s Wort should not be used for the two weeks prior to surgery.
- Quit smoking and arrange for any help you may need at home. Smoking may increase the risk of the hernia recurring, or coming back after surgery. In some cases, your surgeon may require that you quit smoking prior to surgery.
How is the Procedure Performed?
There are few options available for a patient who has a hernia.
- Use of a truss (hernia belt) is rarely prescribed as it is usually ineffective. It may alleviate some discomfort, but will not prevent the possibility of bowel incarceration or strangulation.
- 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. The surgeon may choose to use a small piece of surgical mesh to repair the defect or hole. This technique can be done with a local anesthetic and sedation, using a spinal anesthetic or a general anesthetic.
- The laparoscopic hernia repair is done with the use of 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 separate 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 it may be fixed in place using staples, adhesive sealant, or sutures. 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 or bleeding problems during the operation.
The decision to perform the open procedure is a judgment decision made by your surgeon either before or during the actual operation. When the surgeon feels that it is safest to convert the laparoscopic procedure to an open one, this is not a complication, but rather good surgical judgment. The decision to convert to an open procedure is strictly based on patient safety.
Brought to you by:SOCIETY OF AMERICAN GASTROINTESTINAL AND ENDOSCOPIC SURGEONS (SAGES)
11300 West Olympic Blvd., Suite 600
Los Angeles, CA 90064
- (310) 437-0544
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- March 1, 2015