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LAPAROSCOPIC GROIN HERNIA REPAIR

A groin hernia is an abnormal bulging of tissues from the abdominal cavity into the groin area via a weakness in the abdominal wall structure. Some hernias pass into the scrotum in the male or labium in the female. The bulge contains fat, intestine or fluid which slips into the hernial sack. These contents may be reduceable, irreduceable, obstructed or strangulated.

COMMON SIGNS AND SYMPTOMS.

It usually starts with a bulge and pain or discomfort. This may be pushed back digitally or by itself when lying down. If the contents of the sack become trapped it may suddenly become very painful and constitutes an emergency.

TREATMENT

The best treatment for a hernia is surgical repair. There are many surgical procedures described for hernia repair. Laparoscopic repair is now a safe alternative with many advantages for the patient. The post-operative pain is less and full mobilization is much shorter. It must be done by a surgeon who has experience in the technique. Please discuss this with your doctor who can advise you correctly. The purpose is to reduce the contents and the sack to the abdominal cavity and close the defect with a prosthetic patch material.

PRE-OPERATIVE PREPARATION

- Make sure your doctor knows what medication you are taking and any allergies.
- There are certain predisposing factors which may requ- Make sure your doctor knows what
  medication you are taking and any allergies.
- There are certain predisposing factors which may require attention like chronic cough,
  constipation, smoking and urinary obstruction or difficulty.
- Do not eat or drink anything for 6 hours before theater. Do not shave yourself. This will be done in
  theater. You may be asked to have a wash once admitted.

OPERATION

This will be done under regional or general anaesthetic. Discuss options with your doctor. Surgery will take about an hour.

POST-OPERATIVE CARE

You will be observed in the recovery area to monitor your vital signs. You will also be given pain relief if required. Do not be worried about swelling of the scrotum or crackling sensation of the surrounding skin. This is just gas which will be rapidly absorbed. You will be discharged the same day or the next morning. Arrange follow up date with your doctor. You may sometimes feel a swelling in the same area as your hernia. Do not be concerned .This will go away in the near future.

HOME CARE

Discuss this important recovery period with your doctor. Your strenuous activity should only commence after 14 days. Make sure that you do not become constipated. Discuss return to work with your doctor but sedentary work should be commenced within a week.

COMPLICATIONS

  1. Any surgery is associated with complications but is very uncommon.
  2. A bleed or haematoma may occur at the site of laparoscope insertion or at the groin hernia site. This may at times require reoperation to remove the blood.
  3. Infection of operation site wounds or patch may occur and may require dressings, medication and in very rare circumstances removal of the patch.
  4. Occasionally the nerves in the area may be irritated or damaged causing sensory changes in the area. These may be temporary or permanent.
  5.  Injuries to the structures to and from the testes may very rarely occur. This may cause the testes to later shrink.
  6.  Systemic complications that occur after any operation or anaesthetic .These are extremely rare but may be serious and threaten life.
  7.  These hernias may recur regardless of technique and predisposing factor removal. The incidence varies from 1-10%.