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JAMA Patient Page
October 3, 2017

Laparoscopic Groin Hernia Repair

JAMA. 2017;318(13):1294. doi:10.1001/jama.2017.11620

Laparoscopic hernia repair is performed with general anesthesia and requires use of a breathing tube.

Three half-inch or smaller incisions are made in the lower part of the abdomen. In laparoscopic hernia repair, a camera called a laparoscope is inserted into the abdomen to visualize the hernia defect on a monitor. The image on the monitor is used to guide the surgeon’s movements. The hernia sac is removed from the defect in the abdominal wall, and a prosthetic mesh is then placed to cover the hernia defect. While doing this, surgeons are careful to avoid injuring the nerves that are near the hernia (that can cause chronic pain if injured), blood vessels that can bleed, or the vas deferens (which carries sperm from the testicle and can reduce fertility if injured). The small incisions are closed with stitches (sutures) that dissolve on their own over time. You should discuss all hernia repair options with your surgeon to determine which approach is best for you.

The majority of patients undergoing elective or nonemergent groin hernia repair go home the same day as the surgery once their pain is under control, they have urinated, and they are able to tolerate food or liquids without nausea or vomiting.

Postsurgery Care at Home

Most patients can expect soreness over the first 1 to 2 days after surgery. Take pain medication as prescribed by your surgeon. Some patients may experience bruising (ecchymosis) in and around the groin area. This is normal. However, if there is significant swelling in the groin, you should contact your surgeon. You should walk every day but limit strenuous activity such as running and lifting anything over 5 to 10 lb (the equivalent of a gallon of milk) until evaluated by your surgeon at your postoperative visit 1 to 2 weeks after surgery. In general, if an activity hurts, it shouldn’t be done. Constipation and straining during bowel movements increases the pressure on the repair and should be avoided; eat a high-fiber diet and use stool softeners if needed.

Contact your surgeon if you experience fever higher than 100.4°F, shaking chills, pain that gets worse over time, inability to urinate, inability to eat without feeling nauseous, or redness or pus draining from the incision(s).

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The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.
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Article Information

Conflict of Interest Disclosures: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

Source: Beadles CA, Meagher AD, Charles AG. Trends in emergent hernia repair in the United States. JAMA. 2015;150(3):194-200.

Topic: Hernia

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