Laparoscopic Herniorrhaphy

WHAT YOU SHOULD KNOW:

• Laparoscopic herniorrhaphy, also known as transabdominal preperitoneal (TAPP) repair, is surgery to repair a hernia. A hernia may occur when the muscle layers in your abdomen (stomach) weaken. The weakened muscle layers allow your tissues or organs to push through. When this happens, a bulge or mass (lump) may be seen or felt under your skin. Hernias often occur in your inguinal (groin) area. A hernia may also occur near your genital area (between your inner legs), or upper thigh. Hernias may also form in the front of your abdomen, or in areas of past surgical incisions (cuts).
  
  
• During this surgery, a special tool called a laparoscope is used. A laparoscope is a long metal tube with a light and camera on the end. The laparoscope will be inserted into your peritoneal cavity (the space in your abdomen containing organs). The laparoscope will allow your caregiver to see your hernia. You may have a hernia in one or both sides of your groin in need of repair. Laparoscopic surgery to fix your hernia may strengthen your abdominal muscles, remove your hernia bulge, and decrease your pain.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• You may be allergic to the anesthesia used during your surgery. You may also bleed more than expected during your surgery. During your surgery you may have injuries to your nerves, blood vessels or abdominal organs. The contents of your bowel may spill into your abdominal space and cause a very bad infection. In some cases, a TAPP hernia repair may need to be changed into an open hernia repair surgery. An open surgery means larger and deeper incisions will be made, which will take longer to heal. You may have shoulder and chest pain from the gas used during your surgery.
  
  
• You may have bruising, seroma (collection of fluid), swelling, or infection at your surgery site. After surgery, you may have trouble emptying your bladder. There is a risk of getting a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening.
  
  
• You may have chronic (lasting) pain or numbness in your groin area for months or years after your surgery. You may need to have another surgery if your condition returns or occurs in a different area. If you do not have the surgery, your pain or discomfort may increase. Your soft tissue or bowels may become trapped in your abnormal opening. When tissues and organs are trapped they may become necrotic (tissue death). Trapped necrotic tissue and organs may be life-threatening. Talk to your caregiver if you have questions about your condition, surgery, or care.

WHILE YOU ARE HERE:

Before your surgery:

• Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Pre-op care: You may be given medicine right before your surgery to make you feel relaxed and sleepy. Antibiotic medicine may also be given through your IV to prevent infection. You will be taken on a stretcher to the room where your surgery will be done. You will then be moved to an operating table or bed.
  
  
• General anesthesia: This is medicine that may be given in your IV or as a gas that you breathe. You may wear a face mask or have a tube placed in your mouth and throat. This tube is called an endotracheal (ET) tube. Usually, you are asleep before your caregiver puts the tube into your throat. The ET tube is usually removed before you wake up. With this anesthesia, you will be completely asleep and free from pain during surgery.

During your surgery:

• You will be placed lying on your back with your feet slightly higher than your head. Your abdomen and groin area will be cleaned. Your caregiver will make 3 to 4 small incisions (cuts) around your groin area and into your peritoneal cavity. The laparoscope and other special surgery tools will be inserted through the incisions. Carbon dioxide gas may be used to inflate (make larger) your abdominal cavity. The gas will allow your caregiver to better see the area in need of repair.
  
  
• The weakened muscles in your groin will be checked through the scope. Your caregiver will remove your hernia or push it back into its normal space. A mesh patch will be placed over the area of the hernia and stapled or tacked in place. Your peritoneum (inner tissue lining of your abdomen) will then be closed over the mesh with staples or stitches. The carbon dioxide gas and surgery tools will be removed. Your incisions will be closed with stitches and covered with a bandage. The bandage will help keep your incisions clean and dry, and help to prevent infection.

After your surgery:

You will be taken to a room where you will rest until you are fully awake. Once your caregivers see that you are okay, you may be able to go home. If your caregiver wants you to stay in the hospital, you will be taken to your room. Do not try to get out of bed until your caregiver says it is okay.

• Activity: A caregiver may help you get out of bed to walk on the day of your surgery. Ask your caregiver if there are exercises that you can do while you are in bed. If you feel weak or dizzy while standing up, sit or lie down right away and call your caregiver.
  
  
• Diet: You may be given a high-fiber diet to prevent straining (pushing) during bowel movements. You may need to drink more liquids after your surgery.
  
  
• Medicines:
  
  
  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
    
    
    • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
      
      
    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
    
    

• Ultrasound: An ultrasound is a simple test that looks inside of your body. Sound waves are used to show pictures of your organs and tissues on a TV-like screen. An ultrasound may be needed after your surgery to check your hernia repair.
  
  

Learn more about Laparoscopic Herniorrhaphy (Inpatient Care)