Regarding Your Hernia
Introduction
| In the
modern practice of surgery there are several methods of
inguinal hernia repair. These include: the Shouldice Operation
(Canadian), the use of a synthetic mesh plug via open surgery,
and the laparoscopic repair, also using a mesh prosthesis.
Regardless of the method, the repair can be done as Same Day
Surgery. The particular technique used is determined by the
patient's needs. The Shouldice and mesh plug repairs are
usually done under local anesthesia. The laparoscopic
technique usually requires general anesthesia. An
anesthesiologist will be in attendance at all operations,
however, to monitor vital signs, check the oxygenation of the
blood, and provide sedation as needed. |
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Preparation
You will be
interviewed and examined. If you do indeed have a hernia that
warrants repair, arrangements will be made to admit you to the
hospital's Same Day Surgery unit two hours before the operation.
Preadmission testing will be scheduled as needed. Do not eat or
drink for six hours prior to the time of surgery, but take any
prescribed medications with a small amount of water. All aspirin
products should be discontinued one week prior to surgery.
Operation
A. Open Repair
In the operating room the surgical site
will be washed and local anesthetic administered. It is an injection
of Xylocaine, similar to the one a dentist might administer. The
operation takes about an hour. Very likely you will be dozing
through it, though on several occasions the surgeon will ask you to
strain or cough, first to demonstrate the hernia and then to
demonstrate the repair.
Many patients are initially concerned about
the prospect of local anesthesia. However, our experience with 6,000
patients over the past 25 years has shown this to be a well-accepted
and well tolerated method.
B. Laparoscopic
Repair
This technique
is done under general anesthesia and is performed with specialized
instruments through three small incisions in the midline between the
navel and the pubis. The repair is made with a prosthetic mesh. It
is suitable for those patients for whom a general anesthesia does
not represent a risk. It should also be considered for those
patients who have a hernia of both sides and wish to proceed with
repair of both at the same sitting.
The Aftermath
Upon completion of
the operation, you will be asked to climb from the operating table
to a stretcher and taken to the Same Day Surgery recovery area. Pain
medication will be available to you should you need it. Most
patients will be discharged within one to two hours after surgery.
In the first few days
immediately after surgery, plan to be a "couch potato" so
that the wound and mesh can settle and start healing. After about a
week you may resume all ordinary activities as you find it
comfortable to do so, but never persist beyond pain or fatigue.
Twenty four hours after surgery you may remove the dressing and
discard it. At this time, you may also start showering, washing the
wound with soap and water and dabbing it dry.
People in sedentary
occupations may resume work in about a week to ten days. Obviously,
the more physically stressful occupations will require
proportionally longer convalescence.
A prescription for
pain medication will be provided on discharge. Most narcotic-based
pain medications slow down bowel function. Take two tablespoonfuls
of Milk of Magnesia twice a day to avoid constipation. Continue this
until your bowels are regular.
After you are home,
you will notice swelling around the wound. This firm area, "the
healing ridge," will be reabsorbed over several weeks. It is a
normal reaction of the body to surgical trauma.
The first
postoperative visit to the surgeon will be in approximately one
week's time. Please call the office for an appointment. Should you
have any questions or concerns in the interim, do not hesitate to
contact your surgeon.
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