What is Laparoscopic Inguinal Hernia Repair

Laparoscopic inguinal hernia repair is a surgical procedure to repair a small weak spot in the groin muscles that allows fat or intestine from inside the abdomen to bulge out (inguinal hernia). This procedure may be planned, or it may be an emergency procedure.

During the procedure, tissue that has bulged out is moved back into place, and the opening in the groin muscles is repaired. This is done through three small incisions in the abdomen. A thin tube with a light and camera on the end (laparoscope) will be used to help perform the procedure.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to other structures or organs.
• Long-term pain and swelling of the scrotum, in men.
• Testicle damage in men.
• Inability to completely empty the bladder (urinary retention).
• A collection of fluid that builds up under the skin (seroma).
• The hernia coming back (recurrence).

What happens before the procedure?

Medicines

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
• You may be given antibiotic medicine to help prevent an infection.

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

General instructions

• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• You may be asked to shower with a germ-killing soap.
• Plan to have someone take you home from the hospital or clinic.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.

What happens during the procedure?

• To lower your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Hair may be removed from the surgical area.
  • Your skin will be washed with soap.
• An IV will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to make you fall asleep (general anesthetic).
• Three small incisions will be made in your abdomen.
• Your abdomen will be inflated with carbon dioxide gas to make the surgical area easier to see.
• A laparoscope and surgical instruments will be inserted through the incisions. The laparoscope will send images of the inside of your abdomen to a monitor in the room.
• Tissue that is bulging through the hernia may be removed or moved back into its normal place.
• The hernia opening will be closed with a sheet of surgical mesh.
• The surgical instruments and laparoscope will be removed.
• Your incisions will be closed with stitches (sutures) and adhesive strips.
• A bandage (dressing) will be placed over your incisions.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• You will be given pain medicine as needed.
• You may continue to receive medicines and fluids through an IV. The IV will be removed after you can drink fluids well.
• You will be encouraged to get up and move around, and to take deep breaths frequently.
• Do not drive for 24 hours if you were given a sedative during your procedure.

Summary

• Laparoscopic inguinal hernia repair is a surgical procedure to repair a small weak spot in the groin muscles that allows fat or intestine from inside the abdomen to bulge out (inguinal hernia).
• This procedure is done through three small incisions in the abdomen. A thin tube with a light and camera on the end (laparoscope) will be used to help perform the procedure.
• After the procedure, you will be encouraged to get up and move around, and to take deep breaths frequently.

Care After Laparoscopic Inguinal Hernia Repair

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Pain.
• Swelling and bruising around the incision area.
• Scrotal swelling, in men.
• Some fluid or blood draining from your incisions.

Follow these instructions at home:

Incision care

• Follow instructions from your health care provider about how to take care of your incisions. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.
• Wear loose, soft clothing while your incisions heal.

Driving

• Do not drive or use heavy machinery while taking prescription pain medicine.
• Do not drive for 24 hours if you were given a medicine to help you relax (sedative) during your procedure.

Activity

• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe.
• Ask your health care provider what activities are safe for you. A lot of activity during the first week after surgery can increase pain and swelling. For 1 week after your procedure:
  • Avoid activities that take a lot of effort, such as exercise or sports.
  • You may walk and climb stairs as needed for daily activity, but avoid long walks or climbing stairs for exercise.

Managing pain and swelling

• Put ice on painful or swollen areas:
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.

General instructions

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers. You may only be allowed to take sponge baths.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• To prevent or treat constipation while you are taking prescription pain medicine, your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Take over-the-counter or prescription medicines.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried and sweet foods.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Drink enough fluid to keep your urine pale yellow.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have more redness, swelling, or pain around your incisions or your groin area.
• You have more swelling in your scrotum.
• You have more fluid or blood coming from your incisions.
• Your incisions feel warm to the touch.
• You have severe pain and medicines do not help.
• You have abdominal pain or swelling.
• You cannot eat or drink without vomiting.
• You cannot urinate or pass a bowel movement.
• You faint.
• You feel dizzy.
• You have nausea and vomiting.
• You have a fever.

Get help right away if:

• You have pus or a bad smell coming from your incisions.
• You have chest pain.
• You have problems breathing.

Summary

• Pain, swelling, and bruising are common after the procedure.
• Check your incision area every day for signs of infection, such as more redness, swelling, or pain.
• Put ice on painful or swollen areas for 20 minutes, 2–3 times a day.