Advanced, Pre-peritoneal, Inguinal Hernia Repair Post-operative Information

Surgery

You have just undergone minimally invasive surgery to repair a hernia. This involves making a small incision in your lower abdomen in order to gain access to your hernia or hernias. From the inside of your abdominal wall, the hernia is pulled back out of the inguinal canal (the region in which hernias are formed) and a large piece of mesh is placed inside your abdomen in order to repair the hernia defect from the inside.
The end result of this repair is identical to laparoscopic inguinal hernia repair, but the procedure is less invasive. There is less dissection involved and local anesthesia with sedation is used instead of general anesthesia, leading to a quicker recovery.

Pain

If your prescription was not mailed to your pharmacy before surgery, upon discharge from the hospital, you will be given a prescription for pain medication. Because pain medication can be constipating, be sure to drink lots of fluids and eat plenty of fruits and vegetables. It will also be helpful to take a stool softener such as Senokot or Colace twice a day. Citrucel or Benefiber are good fiber supplements that can be taken once or twice a day in order to prevent constipation .

ICE can be used to alleviate your discomfort. It is safe to ice the incision area and below for 20 minutes at a time, several times a day during the first few days after surgery.

If you are unable to have a bowel movement following surgery, a mild laxative such as Milk of Magnesia may be used. Being up and about after surgery is also helpful in regulating bowel function. To minimize pain when you are moving about, support your incision with a small pillow or rolled up towel. Sleeping with a pillow under or between your knees will relieve stress on the incision area.

Most patients can take Acetaminophen (Tylenol) instead of the prescription medicine. Ibuprofen(Advil) or Naproxen (Aleve) can often be taken in addition to the Tylenol or your prescription. Since most pain medicine can be taken every 8 hours, some people find it helpful to take Acetaminophen every 8 hours and Ibuprofen every 8 hours, but staggered by 4 hours, thus taking something for pain every 4 hours and avoiding narcotics all together. For example, a patient might take Ibuprofen at 1:00 pm, 9:00pm and 5:00 am and Tylenol at 9:00 am, 5pm, and 1 am if needed.
Please read the instructions provided while you were in the hospital, or the bottle of your over the counter medicine if you have questions about this.

Incision

Your incision is closed using a number of sutures below the skin surface. When you remove the outer dressing (see bathing instructions below for when to remove the dressing), you will find a special ribbed tape covering the incisions. The ribbed tape will fall off on its own.
MALE patients may find that your scrotum or penis will become discolored, and you will have swelling in the region of your hernia and incision. FEMALE patients may find that your labia will become swollen and discolored. The swelling does not mean your hernia was not repaired. This swelling and discoloration is normal and will resolve over the next several weeks to months. Sometimes this swelling can feel quite hard, and may seem to appear several days after surgery.
Many patients have used Arnica Montana, either as a gel or orally, to reduce swelling and bruising after surgery. Arnica is a safe, homeopathic medicine that works well in many patients. Most natural food stores will carry it.

Bathing

You have a water proof bandage on your incision. It is fine to shower any time after surgery. Two days after surgery, remove the outer dressing. It is still safe for you to get into the shower. Be careful not to scrub at the incision line; simply let the water run over the incision and gently pat the area dry.
It is fine to swim in a pool or take a bath after the steri-strips have fallen off (or 2 weeks after surgery – whichever occurs first).

Activity

Following surgery, you are encouraged to do as much walking as is comfortable. You may climb stairs, taking them one at a time and slowly.
You are not to operate a vehicle while you are taking pain medication. This will interfere with your ability to drive safely. Once you have finished taking pain medication, it is safe for you to drive.
Lifting heavy objects and exercise is okay two weeks after surgery, but if lifting causes pain in your incision or groin, please stop. If pain persists, call the office and speak with the nurse.

Precautions

Although not commonly seen, any incision is susceptible to infection. If you develop a fever of 101 degrees or above, have unexpected pain, redness or drainage from the incision, please contact my office.
Your pain and swelling should gradually improve after the second postoperative day. Some patients will experience more swelling in the first week, expecially if they are very active. If your symptoms worsen after that time, please call the office

Follow-up

If you do not already have a postoperative appointment, please call the office a day or two after you go home to schedule your appointment for approximately 2 weeks after surgery.

Hernia recovery during cold and flu season

The winter months bring lots of colds and sometimes the flu. If you find yourself needing to cough or sneeze, its often helpful to place a pillow over your incision. This provides some support and comfort, and will hopefully decrease your pain when you cough or sneeze. Sharp pain is not uncommon after a cough or sneeze, and lingering effects should resolve in a day or two. It’s very unlikely that the hernia will return as a result of this.

Call the office if you have questions or concerns about your recovery:
(617) 244-5355