Hernia Surgery  

 

1. What are the options for treatment for an inguinal hernia?

In general the options are as follows: 

An open repair (Liechtenstein)

A laparoscopic approach ( most likely total extraperitoneal)

A robotic approach

Watchful waiting

At your office visit a determination will be made what works best for you.

 

​2. Does my inguinal hernia need to be repaired with mesh?

Almost all hernias today are repaired with mesh. The hernia is a weakness in the abdominalwall and historically if the defect was closed primarily there was a high recurrence rate. With themesh as a bridge the risk of recurrence is much diminished and also the recovery may be lesspainful as there is less tension.​

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3. I have heard some bad things about mesh for my inguinal hernia repair.

Almost all of the negativity around mesh is related to intraabdominal placement of mesh and theuse of “ experimental/new” meshes. Dr Agolini has been using a type of mesh for over 28 yearswithout any problems and this mesh is not placed intraabominally( is placed between layers).

 

4. How quickly will I recover from my inguinal hernia repair?

Most patients have around three days of a medium amount of pain, at around one week areback at non contact jobs.Most patients need at most a few narcotics and many can avoid themall together. In the time period of recovery you will be able to stay active and in fact this isencouraged. Around three weeks there will be no limitations on any activity.

 

5. Why do I have bruising or swelling in my scrotum/ or area of my prior hernia?

After hernia repair the opening of the hernia in the abdominal wall has been closed. Howeverfluid can build up in the space that the hernia used to occupy. This can manifest as a lump afterthe hernia repair and is normal. It will almost always resolve on its own. The larger the herniapreoperatively and the longer it has been present are risk factors for larger fluid collections afterthe surgery. Sometimes we will place a binder to try to minimize the amount of fluid that collects

 

6. What is the difference between laparoscopic and robotic surgery?

They are both minimally invasive techniques that allow small incisions to repair hernias. In somecases one technique may be preferred to another. In general abdominal wall and especiallyincisional hernias are better served with a robotic approach. This is because with the aid of therobot the surgeon can suture closed any of the defects and also allows the placement of largepieces of mesh. On the other hand small inguinal hernias can be repaired laparoscopically witha quicker surgery and less invasive than the robot.

 

7. When will I be able to resume full activity?

This will be determined at your postop visit but in general for laparoscopic and robotic herniarepairs you may be back at full activity as soon as three weeks.

 

8 Why might I be asked to lose weight before surgery?

With all hernia surgeries there is a risk of recurrence. More weight increases the risk. This ismost relevant for abdominal wall( umbilical, ventral and especially incisional hernias). In generalit is ideal to have a bmi less than 35 for abdominal wall hernia repair. We can help get you on agood plan to reduce surgery before surgery. Also patients are motivated

 

9. Why must I stop smoking before surgery? 

Nicotine impairs healing. After surgery especially with hernia repairs it is important that thetissues repair themselves and that the mesh integrates into the repair.Additionally patients who smoke tend to cough as they emerge from anesthesia which putsunwanted pressure on the repair