Inguinal hernia repair

Inguinal hernia repair
Procedure Repair of inguinal muscular canal defect through which bowel protrudes
Time 30–60 min
Pain ++/+++
Position Supine
Blood loss Not significant
Practical techniques GA, SV LMA, inguinal field block
Spinal
Local infiltration and/or sedation
Preoperative
  • Patients are usually adult males or young children.
Perioperative
  • Will need opioid if not using a local technique.
  • If using an inguinal field block the surgeon may need to inject a local anaesthetic into the spermatic cord. More likely if the genitofemoral nerve is not blocked preoperatively.
Postoperative
  • Significant co-morbidity associated with age—give supplemental oxygen for 24 h.
Special considerations
  • May be booked as a day case procedure.
  • If day case, prescribe opioid analgesia to take home, e.g. tramadol 50–100 mg fo ur times a day.
  • Laparoscopic hernia repair (see earlier).
  • Some surgeons do all inguinal hernias under local anaesthetic, some none. In a high-risk patient repair under local anaesthetic is best.
  • Mesh insertion usually requires administration of prophylactic antibiotics.
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