You have just undergone laparoscopic inguinal hernia repair. This involves making small incisions higher up in your abdomen, inflating your abdomen with a gas, and working from the inside to get to the layer of the abdominal wall where the hernia hole is present. The hernia is then patched on the inside with mesh. This type of repair always requires general anesthesia and local numbing medicine is also used.
Soreness or pain at the incisions, the lower abdomen, and groin after surgery is normal. Pain will be worse with movement, changing positions from laying to seated to standing. Male patients may notice new pain in the testicles after surgery. This is normal and will go away over time.
Additionally, pain can extend into the shoulders – this pain is due to a small remaining amount of gas within your abdominal cavity. This gas was used to inflate your abdomen in order to do the surgery. While we try to vent all of this gas out at the end of the surgery it is impossible to get all of it out. This small amount of gas causes some irritation of the lining of the abdominal cavity and our brain sometimes translates this to pain in the shoulder. The gas dissipates on its own over 24-48 hours and nothing needs to be done. It will get better!
Most of our patients take only Tylenol and ibuprofen for pain management after surgery. If you have been advised in the past not to take one of these medications, please follow those instructions. Applying ice to the surgery sites for 20 minutes at a time can also be helpful.
We recommend taking the following (if allowed) every 6 hours for the first few days after surgery as needed:
If you are experiencing significant pain that is preventing you from going on a walk or falling asleep, please call the office to discuss prescription pain medications. Opioid pain medications like oxycodone, will cause constipation, so we recommend following the instructions below for constipation.
Constipation is a common side effect of anesthesia and surgery, and even more common if you are also using opioid pain medication.
If you have a history of constipation or require opioid pain medications:
You’re not alone: Many people experience constipation after hernia surgery – it may take time, but this too shall pass!
The incisions are closed with dissolvable sutures – these do not need to be removed.
You will either have surgical glue or a plastic bandage over your wound.
Bruising in the groin and genitals is normal after surgery. 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. This discoloration and swelling will resolve with time.
Some patients will feel a firm lump in the area where their hernia used to bulge. Most of the time this is fluid in this area – called a “seroma” – this will resolve within a few months.
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.
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 pus draining from the incision, please contact our office.
Your pain and swelling should gradually improve after the second or third postoperative day. If you have new, constant pain after feeling good for a couple of days, please contact our office.
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. We recommend walking at a leisurely pace for the first 2 weeks.
Avoid exercise, strenuous activity, lifting over 25lbs, and repetitive actions for 2 weeks after surgery. After 2 weeks, you may slowly resume these activities, but do so slowly and progressively, and listen to your body if it is telling you to stop or slow down.
You may drive 24 hours after surgery if you feel up to it, as long as you are not taking any prescription pain medications. We typically recommend you avoid driving for 48-72 hours unless necessary.
You may shower at any time after surgery. There is either waterproof glue or a waterproof bandage over your incision. Once this bandage is removed (48 hours after surgery), you can continue to shower with the steri-strips over the incision. You do not need to put a new dressing over the top.
Please avoid baths, hot tubs, pools, or soaking in water for 2 weeks after surgery, as this can increase your risk of an infection.
You will have a post-operative appointment scheduled between 3 and 5 weeks after surgery. If you do not see this scheduled, or if you need to reschedule, please contact our office.
The winter months bring lots of colds and sometimes the flu. If you find yourself needing to cough or sneeze, it’s often helpful to place a pillow or your hand over your incisions. 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.