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Femoral hernia repair

Definition

Femoral hernia repair is surgery to repair a hernia near the groin or upper thigh. A femoral hernia is tissue that bulges out of a weak spot in the abdominal wall. Usually this tissue is part of the intestine.

In surgery to repair the hernia, the tissue is pushed back in, and the weakened area is sewn closed or strengthened. This repair can be done with open or laparoscopic surgery.

Alternative Names

Femorocele repair; Herniorapphy; Hernioplasty

Description

You will probably receive general anesthesia (asleep and pain-free) for this surgery. If your hernia is small, you may receive local anesthesia and medicine to relax you. You will be awake but pain-free.

In open surgery:

• Your surgeon will make an incision (cut) in your groin area.
• Your surgeon will find the hernia and separate it from the tissues around it. Some of the hernia tissue may be removed. Your surgeon will push the rest of the hernia back inside your abdomen.
• Then your surgeon will close your weakened abdominal muscles with stitches.
• Often a piece of mesh is also sewn into place to strengthen your abdominal wall. This repairs the weakness in the wall of your abdomen.

Your surgeon may use a laparoscope instead of doing open surgery.

• A laparoscope is a thin tube with a tiny camera on the end that allows your surgeon to see inside your body.
• Your surgeon will make 3 or 4 small incisions and insert the laparoscope and other small instruments through them.
• The same repair will be done as the repair in open surgery. The benefits of this surgery are a faster healing time and less scarring.

Why the Procedure Is Performed

All femoral hernias need to be repaired, even if they do not cause any symptoms. If the hernia is not repaired, the intestine can get trapped in the hernia (called an "incarcerated" or "strangulated" hernia). This would cut off the blood supply to your intestines. This can be life threatening. If it happens, you would need emergency surgery.

Risks

Risks for any anesthesia are:

• Reactions to medicines
• Breathing problems, such as pneumonia
• Heart problems

Risks for any surgery are:

• Bleeding
• Infection

Risks for this surgery are:

• Long-term pain
• Damage near the reproductive organs, for women
• Return of the hernia
• Damage to blood vessels that go to the leg

Before the Procedure

Always tell your doctor or nurse if:

• You are or could be pregnant
• You are taking any drugs, supplements, or herbs you bought without a prescription

During the week before your surgery:

• Several days to a week before the procedure, you may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), warfarin (Coumadin), naproxen (Aleve, Naprosyn), and other drugs like these.
• Ask your doctor which drugs you should still take on the day of the surgery.

On the day of your surgery:

• Do not eat or drink anything after midnight the night before surgery.
• Take your drugs your doctor told you to take with a small sip of water.
• Your doctor or nurse will tell you when to arrive at the hospital.

After the Procedure

Most people can go home the same day as surgery, but some may need to stay in the hospital overnight.

After surgery, you may have some swelling, bruising, or soreness around your incision. Taking pain medicines and being careful with how you move can help. You can return to light activities soon after this operation, but you will have to avoid strenuous activities and heavy lifting for a few weeks.

Outlook (Prognosis)

The outcome of this surgery is usually very good. The femoral hernia returns in less than 3 out of 100 patients who have this surgery.

References

Malangoni MA, Rosen MJ. Hernia.In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 44.

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