Laparoscopic Inguinal Hernia Repair

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Opal Logan
5 years ago
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1 1 Laparoscopic Inguinal Hernia Repair Hernia is a medical condition where a part of the intestine bulges out of the weak abdominal muscles. Inguinal hernia is a type of hernia which occurs in the groin region (between the abdomen and thighs). Using Laparoscopic surgery, the part of the bulging intestine in the groin area is pushed inside and the hole is repaired. It is always advisable to go in for a planned surgery for the removal of inguinal hernia. What is the procedure code needed by insurance company for Inguinal Hernia repair? Please quote T2000 and S5210 for local anesthesia post-procedure. What are the indications and contraindications? The indications and contraindications for laparoscopic inguinal hernia repair include: Indications for laparoscopic hernia repair over open repair may include recurrent hernias, bilateral hernias, and the need for earlier return to full activities. Contraindications specific to laparoscopic hernia surgery include non-reducible inguinal hernia, previous peritoneal surgery, and inability to tolerate general anaesthesia.medical conditions including upper respiratory tract or skin infection and poorly controlled diabetes mellitus should be fully addressed and the surgery should be delayed accordingly What is the pre-surgical preparation required? Pre-surgical preparation includes: Follow instructions regarding avoiding certain medications prior to the surgery Fast for 12 hours before the surgery. Report to the hospital at the specified date and time. Routine medical tests will be performed. Enema might be given to clear the bowels. What happens on the day? Laparoscopicinguinal hernia repair includes the following steps: General anaesthesia is administered. Copyright 2015 Gastrosurgery UK Mr Abhay Chopada - 1 /

2 2 Small cuts are made in the abdomen. A laparoscope with a miniature video camera is inserted through one of the cuts. The camera is connected to a video monitor where the surgeon can view the insides of the abdominal cavity. Hollow metal tubes, known as ports are entered into the other cuts. Through these cuts various instruments required in the surgery will be inserted. Carbon dioxide gas is blown into the abdomen. This will lift the abdominal cavity away from the internal organs. This helps the surgeon a better view of the inside. The surgeon locates the protruding intestine and pushes it back into the normal position. If the defect is small, the defect is stitched up.if the defect is large, a nylon mesh is either stapled or sewn in place where the hernia is present. The instruments are removed and the gas is allowed to escape. The cuts are also either stitched or stapled together. What post-operative care is necessary? Post-operative care includes: Once the drip is removed after the operation, you can take small sips of water. You will be able to leave the hospital after you have recovered from the anaesthesia. As some pain is expected after the surgery, you will usually be prescribed some painkillers. A day after the surgery, you will have to go back to remove the dressings from the wound. The pain should wear off in 7-10 days. If the pain does not go, contact your doctor. Start moving about as fast as possible to avoid the formation of blood clots in your legs. Perform deep breathing exercises every hour. This will prevent secretions in the lungs from becoming stagnant, avoiding chest infection. If you experience any side effects like headache, nausea, vomiting due to anaesthesia, you must inform your nurse. What are the risks? As with any surgical procedure, laparoscopic inguinal hernia repair involves certain risks and potential complications. They include: Sometimes the laparoscopic surgery might not work. Open surgery will have to be performed to repair the inguinal hernia. The blood vessel, gut or the bladder could be damaged due to the sharp instruments used in the surgery. Further surgery will be required to correct the problems. Gas bubble in heart or lung: This can happen very rarely. If occurred, complete observation will be required as this condition is fatal. You might face difficulty in passing urine. You might have to use a catheter for the same. In male patients swelling of testicles and scrotum could occur due to the tissue damage during surgery. Draining of the scrotum may be required.the sperm tube may be damaged resulting in infertility in about 1% cases.the position of the testicle may change after the surgery. There could be pain and discomfort in the groin if a small nerve is caught in a stitch during surgery. Copyright 2015 Gastrosurgery UK Mr Abhay Chopada - 2 /

3 3 Infection of the wound may occur in about 1% cases. Bleeding of the wound may occur in some cases.scars will turn red and painful if the wound does not heal normally. There is about.3 to 1% chance of hernia returning back after surgery. For obese people and smokers, there is more risk of wound infection leading to chest infection, thrombosis and also heart and lung complications. You should seek medical help if there is heavy bleeding from the wound, fever and chills, pain, abdominal swelling and tenderness around the wound. Advantages and disadvantages Advantages of laparoscopic inguinal hernia repair include: Less post-operative pain with smaller incisions and faster recovery No further incisions required for patients with hernias in both groins (bilateral hernia) Ideal method for patients with recurrent hernias after previous surgery Early discharge from hospital Earlier return to work Disadvantages over open surgery include: General anaesthesia is required Expensive procedure Unproven recurrence rate in the very long term Post Surgery Information Sheet Post Surgery Information Sheet for Hernia repair Frequently Asked Questions about what to expect after Hernia repair Q1. Will I be able to go home on my own after the surgery? A. No, you will not be able to go home on your own, due to the effects of anesthesia. Someone should be present to drive you home. Q2. When are the stitches to be removed? A. The stitches or staples which close your wound will be removed after 7-10 days. You will need to go to the day ward for the removal of stitches. The surgeon will already have informed you of the date and time before you go home. If dissolvable stitches are used, they will dissolve automatically within 2-3 weeks. Q3. Will I experience pain after the surgery? A. Yes, you can experience pain after the surgery. This pain will usually occur when you move about. Q4. What should I do if experience pains? A. You should take the prescribed pain-killers to help combat the pains. Copyright 2015 Gastrosurgery UK Mr Abhay Chopada - 3 /

4 4 Q5. Can I shower once I reach home? A. No. You can shower only after 48 hours after the surgery. Till then you should keep the dressing on your wound dry. Q6. When should I change the dressing on the wound? A. You can remove the dressing from the wound when you take a shower after 2 days of surgery. After drying the wound you may cover the wound with a dressing for another 1-2 days. After that, you may leave the wound open to let the air get into it. Q7. Should I take any other precautions after the surgery? A. Yes. You should remain at home for at least 1 day to help you recover from the effects of anesthesia. You should also avoid lifting heavy objects at least for 2 months. Q8. When can I resume my normal diet? A. You can start eating and drinking normally once you reach home. You must remember to include fibre in high quantity to avoid constipation. Also drink lots of fluids. If you do not pass stools even after 3 days, take some laxatives. Q9. When can I resume my normal activities? A. You can start walking after 1 day. Two weeks after the surgery you can start driving. Depending on your job, you can return to work after 2 weeks 6 weeks after surgery. Sports and other vigorous activities are to be avoided at least for 3 months. Q10. What should I do if I problems arise due to surgery? A. You must contact your local doctor in case of problems like fever, redness and swelling of the wound. You must immediately call for emergency in case there is heavy bleeding from the wound. Downloadable Post surgery Information sheet Contact Details: For additional information and appointments, please contact us at +44 (0) Alternatively, you can us your queries at mailto: gastrosurgery@gmail.com. Disclaimer: Information provided is only for educational purpose. Contact your Health consultant or Emergency services depending on your symptoms. Do not selfdiagnose, treat or take health care decisions based on the information given. It cannot replace a medical consultation required for a patients individual needs. We also do not control or guarantee the information given on any external links provided on our site. Copyright 2015 Gastrosurgery UK Mr Abhay Chopada - 4 /

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