Laparoscopic inguinal hernia surgery

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Risks of laparoscopic inguinal hernia surgery

Conversion to an open procedure 

It may be necessary for your surgeon to make a larger incision to finish inguinal hernia repair safely less than 5% of the time. This may be necessary because of dense scarring from prior surgeries, bleeding, inability for important landmarks to be adequately visualized by the surgeon, or inability to optimally repair the hernia in this manner. The surgeon will use his or her best judgment to do what is safest in any particular situation.

Persistent pain following surgery  

Pain and discomfort from inguinal hernias are typically the motivating symptoms leading to hernia surgery. In addition to repair of the hernia and elimination of any bulge, it is the goal of hernia repair to resolve any pain or discomfort. Persistent pain may continue in about 6 % of people who undergo laparoscopic inguinal hernia surgery. This is because there are 3 nerves in the area of the surgery which can cause persistent sensations resulting in pain or discomfort.  The risk is higher if the surgery is for a recurrent hernia, or if the surgery has to be converted to an open surgery.

Infection  

Infection at the small incision sites can be seen in less than 1% of people undergoing laparoscopic inguinal hernia surgery. This can usually be treated without additional surgery. More serious infections deeper in the abdomen involving the mesh repair are less common. A deeper infection may require removal of the mesh to clear the infection.

Incisional hernia  

Hernias develop in less than 1% of people having laparoscopic inguinal hernia surgery.  Hernias occur when the muscle layer at an incision fails to heal, and are recognizable as a swelling or bulge beneath one of the scars developing weeks to months after surgery. A firm knot or bulge beneath the incision within the first few days after surgery is normal, and is rarely a hernia. Repair of this type of hernia requires a surgical procedure, usually as an outpatient.

Bleeding  

Bleeding from the skin incisions is typically minimal, rarely dangerous and often will stop with application of gentle pressure. Bruising may commonly be seen, especially in individuals on aspirin or blood thinners. More serious internal bleeding associated with injury to larger blood vessels is known to occur in less than 0.5% of surgeries. This is typically recognized at the time of surgery and may require conversion to an open procedure.

Injury to other structures  

The approach for laparoscopic inguinal hernia repair is through the abdomen. Injury to the small bowel or colon might occur and risks is higher in individuals who have had prior abdominal or pelvic surgeries.  Such injuries are uncommon, occurring in less than 1%. Conversion to an open surgery may be required to repair these injuries, and placement of mesh may be postponed to minimize risk of infection of mesh.

Swelling or bruising 

Significant bruising and swelling occurs frequently following laparoscopic inguinal hernia repair.  Such bruising and swelling may worsen over a period of 3 to 5 days before gradually returning to normal.  Wearing an athletic supporter or snug underwear might help with any discomfort..

Bowel obstruction  

Any surgical procedure, including inguinal hernia repair, can result in formation of scar or adhesions. Such scarring in the abdomen is associated with a risk of bowel obstruction.  Bowel obstruction is seen very rarely following laparoscopic inguinal hernia repair surgeries.

Death  

Death is uncommonly related to inguinal hernia surgery. Healthy individuals have a less than 1 in 1,000 chance of death. Risk of death increase with other medical problems such as heart disease, COPD, diabetes, obesity and other medical conditions. Age also increases the risk of death associated with gallbladder surgery, but a reasonably healthy individual 70 years of age has a risk of death of only about 2%.