3.- What cases the hernia? It is unknown. Sometimes it is related to violent exercise or some trauma; you begin feeling discomfort and later the lump appears in the groin. It is also related to chronic illnesses that produce pressure in the abdomen, as for example chronic cough. 4.- What are the advantages of the laparoscopic repair? Through a three small incisions, gas is introduced in the abdomen and then the hernia can be repaired with a mesh that is fixed to the abdominal muscles and the pubis with special staples. Thanks to laparoscopy, the recovery is faster and less painful, so the patient can get to their normal life (except for physical exercise) in 7-10 days after the intervention, and they can be discharged fro hospital 12-24 hours after the intervention. 5. 5.- When is laparoscopic surgery indicated? In two cases, fundamentally: - Bilateral inguinal hernia recurrent groin hernia, already treated with open surgery The patient is given general anesthesia. It is indicated in certain cases, but there are also CONTRAINDICATIONS: - Patients that have had their prostate operated on with open surgery - Those of general anesthesia 6.- How should patients get prepared? Most patients need a basic preoperative preparation: blood test, chest x-ray, and electrocardiogram for the anesthesia team. In case the patient presents any associated illness, then some special tests may be necessary. The day before the intervention, it will be necessary to proceed with thorough personal hygiene every 12 hours. It is convenient to carry out a cleaning enema 12 hours before the intervention. Complete fasting (LIQUIDS INCLUDED) 6 hours prior the intervention is also necessary.
The patient will inform their surgeon about the medicines they are taking before the intervention. For example, it is necessary to stop taking any drug that alters clotting (like aspirins or Sintrom) and substitute them for others that the doctor will decide. 7.- How does the procedure take place? You must bear in mind that those hernias that are not operated on will never disappear, but sometimes the surgical risk is so high that surgery is not recommended. In such cases, the patient is advised to use a "truss", although this circumstance is very infrequent nowadays due to the progresses made in anesthesiology and surgery. The intervention can be done with open surgery or laparoscopy. In both cases the problem is solved with a mesh that is fixed to the abdominal muscles with stitches or special staples. In case you are candidate for the laparoscopic approach, a few small incisions will be made on your abdomen (under general anesthesia). Through them, the surgeons will introduce an optical TV device as well as the mesh, and the hernia will be repaired. 8.- What happens if laparoscopy is not feasible? The intervention will be done with open surgery performing an incision in the abdominal region where the hernia is located. It is not a laparoscopic complication but a decision that the surgeon takes in order to ensure the most adequate or indicated technique for each patient. Proceeding with open surgery is based exclusively on the security of the patient. 9.- What happens after the surgical intervention? After surgery, you will stay for 1-2 hours in a room to recover from the anesthesia and then you will be taken to your room, where you will be able to take liquids and solid food progressively. When you can walk, you will be discharged from hospital, but will be able to move from the very same intervention day. If the reparation has been done laparoscopically, the patient can get to their normal life in 7-10 days (except for physical exercise). They will have to visit the doctor 10 days after to get the stitches removed. The second checkup will take place after 15 days and the last one 30-40 days after the intervention. The patient will then be able to do physical exercise.
10.- What complications may arise? They are infrequent, but hemorrhages, infections, or injuries in abdominal viscera (bowel, urinary bladder) may appear. The latter are the most infrequent of them all, but they must be mentioned due to their complexity. We cannot ensure 100%that the hernia will not appear again, but thanks to the use of the mesh, the chances of a relapse have decreased considerably. 11.- When should I call the doctor? - Temperature over 38º - Hemorrhages Increasing abdominal pain or abdomen swelling - Incapability to urinate. - Reddening or suppuration of the wound - Respiratory symptoms like persistent coughing or costal pain
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