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Patient information
A minimally invasive method of repairing inguinal hernias, with reduced scarring and generally an enhanced recovery compared with open surgery.
Laparoscopic inguinal hernia repair is ideally suited to patients who have hernias on both sides, or hernias that have recurred after previous open surgery. It is also a very good option for hernias on one side, as there is reduced scarring and generally an enhanced recovery compared with open hernia surgery.
The operation is performed under general anaesthesia via three incisions: two small incisions of about 5–10mm in each flank, at the side of the abdomen, and a third within the umbilicus. The repair is completed inside the abdominal cavity, with the mesh placed behind the peritoneal layer.
It is usually performed as a day case, unless it takes place in the late afternoon or evening when an overnight stay is often necessary.
After the operation there is some soreness at the incisions and at the site of the hernia repair where the mesh has been placed. This varies, but is usually uncomfortable for the first couple of days and then slowly resolves, with generally pain-free walking and movement by 2 weeks.
Mr Crinnion encourages patients to mobilise as soon as possible and to take regular pain relief for the first 2 days. He recommends ibuprofen (taken with food – 2 tablets 3 times a day) and paracetamol (2 tablets, 3–4 times a day). Stronger painkillers will be provided if necessary for the first couple of days. After the first 48 hours, take pain relief as needed.
There is a good clinical outcome from this operation. Some intermittent twinges of pain may be felt in the groin, and occasionally the testicle, for the first few weeks as exercise is resumed. Generally these settle, with a good long-term result.
The operation is conducted inside the abdominal cavity, so there is a risk of damaging nearby structures, including the bladder, bowel or blood vessels. The risk of an injury requiring an emergency repair is remote – about 1 in 500 operations, based on large databases.
Can occur with any inguinal hernia repair; after laparoscopic repair the risk is about 1–2%.
Nerve irritation may cause sharp or persistent pain. This is uncommon after laparoscopic repair; the risk of significant chronic pain is about 1%.
Meticulous care is taken, but bleeding can cause swelling, particularly in the scrotum. Bleeding needing further surgery is very uncommon (about 1 in 500).
Temporary difficulty passing urine can occur (about 1 in 50). Occasionally a catheter is needed; there are no long-term consequences.
Minor wound infection occurs in about 2% and settles with wound care or antibiotics. Mesh infection is extremely rare (about 1 in 1,000).
An extremely rare theoretical event in which bowel sticks to exposed mesh, which could cause abdominal pain and vomiting.
A hernia can develop where the camera is inserted at the umbilicus (about 1%). Avoid severe strain on the core muscles for a few weeks.
After any operation under general anaesthetic there is a small risk of deep vein thrombosis.
It is usually painful over the first few days. Gentle walking and moving around every hour or so, with rest in between, is recommended. Once it feels reasonably comfortable, increase your walking and begin very gentle stretching of the area. You must not worry about moving – this will not compromise the repair.
The flank wounds are usually covered with tissue glue and the umbilical wound with an adherent dressing. You can shower straight away and remove the adhesive dressing after 7 days.
Mr Crinnion will review you at about 2 weeks. At this stage he generally recommends starting aerobic exercise such as jogging and cycling and some general non-resisted abdominal movements. Heavy core exercise or lifting weights with the trunk should be avoided for 6 weeks, although you can lift weights that do not strain the groin. Please discuss any questions about your rehabilitation.
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Please contact Mr Crinnion’s secretary, Maxine Levene.
Tel: 0787 028 0264
Email: enquiries@jamescrinnion.co.uk
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Mr Crinnion’s office is happy to help before and after your procedure.