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Laparoscopic Inguinal Hernia Repair

Laparoscopic Inguinal hernia repair is an operation performed to repair an inguinal hernia. It has the advantages over an open inguinal hernia repair in smaller incisions, less post-operative pain and an earlier return to normal activities and work. Another great advantage is that bilateral hernias can be done through the same small incisions. The operation is performed under a general anaesthetic (fully asleep). A 1cm incision is made adjacent to the umbilicus (belly button). Two further incisions of about 5mm are made in the lower abdomen. A space is created between the abdominal muscles and the peritoneum (lining of the abdominal cavity). The hernia sac is reduced and a mesh is placed over the hernia defect and secured with a few absorbable tacks. The wounds are sutured with dissolvable stitches and dressings are placed.

What to expect post–operatively

Hospital stay

Most people spend one night in hospital and can be discharged in the morning following the surgery

Recovery

Most people recover well and reasonably quickly and feel almost back to normal within 2 – 4 weeks. It is normal to have groin swelling and bruising and this can be particular apparent in the scrotum in males. Usually, people require 1 – 2 weeks off work but this can be longer if one has a physical job.

Pain

Pain is usually well controlled with simple pain killers. You should take regular analgesia in the first 48 hours including paracetamol (Panadol) 1g (2 tabs) every 4-6 hours (max 8 tabs per day) and an anti-inflammatory such as ibuprofen (nurofen) 400mg every 4 – 6 hours. You may be given a prescription for a stronger pain killer such as oxycodone (endone) or tramal (tramadol) to use in addition as well. After 48 hours, use the painkillers only if needed.

Wounds

The wounds will be closed with dissolvable stitches that are underneath the skin and therefore don’t need removing. The stitches can take months to fully dissolve. A dressing will be placed over the wound. Leave this on for at least 48 hours. You can wash or shower with these water-proof dressings. Once removed, there will usually be steristrips on the wound. These usually remain for a week. If they haven’t fallen off by a week, peel them off.

Exercise

Don’t do any strenuous activities for 4 weeks. Don’t lift anything over 1-2kg during this time. Walking and normal activities around the house is encouraged if you feel comfortable enough. After 4 weeks, you can start doing more strenuous activities if there is no pain or discomfort.

Complications

  • Bleeding – Bruising and swelling is common, significant bleeding is very rare.
  • Infection – Uncommonly, the wounds can get infected. This can usually be treated by antibiotics.
  • Chronic pain – In all hernia surgery, there is a small proportion of people who have pain in the groin continuing after 6 weeks. There are a variety of causes for this. Most chronic pain resolves with time. Occasionally, medications or other interventions are needed to help with the pain.
  • Hernia recurrence – the recurrence rate is approximately 1 – 2%.
  • Conversion to open surgery – Uncommonly (1-2%), the surgery cannot be completed by the keyhole method and an incision in the groin is needed to complete the operation.
  • Prince of Wales Private Hospital
  • The Royal Hospital For Women Foundation
  • Colorectal Surgical Society of Australia and New Zealand
Randwick Rooms

Prince of Wales Private
Suite 17, Level 7
Barker Street
Randwick NSW 2031

Phone: 1300 553 347
Fax: (02) 9650 4924

Double Bay

Double Bay Day Hospital Specialist Suites
Suite 3.01, Level 3, commercial
451 New South Head Road
Double Bay

Phone: 0290 863 133
Fax: (02) 9086 3123

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