Inguinal hernia surgery steps

Before performing inguinal hernia surgery, many related examinations need to be done to better assist the operation. This operation is mainly a repair surgery caused by weak muscle fascia or congenital abdominal wall defects. However, certain precautions need to be taken after the operation to avoid affecting wound healing. So what are the specific steps of inguinal hernia surgery?

Anesthesia method

The main methods include the following:

(1) General anesthesia;

(2) continuous epidural anesthesia or subarachnoid anesthesia;

(3) Local nerve block anesthesia.

Preoperative preparation

(1) A physical examination and necessary auxiliary examinations should be performed before surgery. Elderly patients should pay special attention to the functions of important organs such as the heart, lungs, liver, and kidneys;

(2) quit smoking before surgery;

(3) Complete skin preparation of the surgical area one day before or on the day of surgery;

(4) Patients taking aspirin should stop taking the drug or adjust their medication regimen under the guidance of a physician;

(5) If there is an upper respiratory tract infection, chronic cough, chronic constipation, or other conditions that cause persistently elevated intra-abdominal pressure, surgery should be performed only after the conditions are controlled or improved.

Indications

Suitable for various types of inguinal oblique hernia, direct hernia and femoral hernia, including various primary hernias and recurrent hernias.

Contraindications

Patients with inguinal hernias who do not have incarceration or strangulation should not undergo surgery in the following circumstances.

1. Those who suffer from serious diseases of important organs such as heart, lung, liver, kidney, or other acute diseases, or those with persistent increased intra-abdominal pressure due to severe cough;

2. Elderly hernia patients who are not expected to live long and have no serious symptoms.

Surgical procedures

The general steps of the operation are as follows:

1. Open surgery makes an incision in the groin area, while laparoscopic surgery creates pneumoperitoneum and establishes an operating hole;

2. Separate the gap within the repair range and deal with the hernia sac (different surgical methods have great differences);

3. Repair the defect by suturing or implanting a patch;

4. Close the incision or puncture.

Postoperative Care

1. Lie flat temporarily after surgery. Patients under hemiplegia anesthesia should avoid raising their heads or getting out of bed within 6 hours. Patients under local anesthesia have no special restrictions on their body position after surgery. If there is nausea and vomiting, the head should be tilted to one side to prevent aspiration during vomiting. After 6 hours of tension repair surgery, the patient can take a semi-recumbent position with a soft pillow under the knees and the hip joint slightly flexed to reduce the tension on the abdominal wall. The postoperative activity conditions vary according to different methods. After tension repair, the patient should lie flat for 3 to 7 days. After tension-free repair, the patient can usually get out of bed 6 hours later. However, if the patient needs to get out of bed on the day of surgery, he or she must be accompanied by someone. Later, the patient can gradually get out of bed, do appropriate activities and gradually increase the amount of activity, but he or she must do it within his or her ability.

2. Usually after fasting for 6 hours after surgery, you can eat an appropriate amount of semi-liquid food and gradually transition to normal food. There are no special restrictions on the diet of patients under local anesthesia after surgery. It is recommended to eat more vegetables, fruits and other foods that are conducive to defecation. If there is no bowel movement, avoid eating milk, soy milk, soy products and other foods that are easy to cause bloating. If defecation is difficult, ask the bed doctor to use enema or laxatives.

3. Elderly patients and patients with prostatic hypertrophy will have a urinary catheter placed after anesthesia, which will usually be removed one to two days after the operation; patients without a urinary catheter should urinate as soon as possible when they feel the urge to urinate, and avoid holding urine to cause urinary retention; some patients may have difficulty urinating due to anesthesia, etc., and hot compresses, massage, water flow induction and other methods can be used first. If these methods do not work, catheterization is required.

4. The day of surgery is the day when the incision pain is most significant, and you can ask the doctor to use painkillers.

Precautions

Basic daily life and work (mental work) can be resumed 1 to 2 weeks after the operation. Factors that increase abdominal pressure should be avoided within two months after the operation, such as coughing, sneezing and constipation caused by colds, and weight bearing, long-term walking, repeated going up and down stairs, riding a bicycle, driving and physical exercise should be avoided. The amount of activity can be gradually increased later, and normal life and work can be fully resumed 2 to 3 months after the operation.