49561 Repair initial incisional or ventral hernia; incarcerated or strangulated

Name of the Procedure:

Repair initial incisional or ventral hernia; incarcerated or strangulated. Common name(s): Hernia repair surgery, ventral hernia repair, incisional hernia repair.

Summary

In layman's terms, this surgery involves fixing a hernia that has developed at the site of a previous surgical incision or in the abdominal wall. Specifically, it addresses hernias that have become trapped (incarcerated) or have compromised blood supply (strangulated).

Purpose

This procedure addresses hernias that have protruded through a weakened area of the abdominal wall or a surgical incision site. The goal is to prevent further complications, relieve pain, and restore normal function to the affected area.

Indications

• Abdominal bulge or swelling at the site of a previous surgery.
• Pain or discomfort at the hernia site.
• Symptoms of nausea, vomiting, or abdominal pain indicating possible strangulation.
• Visible hernia that changes in size with activity or pressure.

Preparation

• Fasting for at least 8 hours before the procedure.
• Discontinuing certain medications like blood thinners, as directed by the physician.
• Preoperative imaging tests, such as an ultrasound or CT scan, to assess the hernia.
• Medical history review and physical examination.

Procedure Description

1. Anesthesia: Administered general anesthesia for the procedure.
2. Incision: A surgical incision is made near the hernia site.
3. Hernia Repair: The trapped or strangulated tissue is carefully repositioned.
4. Mesh Placement: A synthetic mesh may be used to reinforce the weakened area.
5. Closure: The incision is closed with sutures or staples.

Tools and technology may include surgical scalpels, laparoscopes (in minimally invasive cases), and synthetic mesh materials.

Duration

Typically, the procedure takes about 1 to 2 hours, depending on the complexity of the hernia.

Setting

The procedure is performed in a hospital setting, often in an operating room.

Personnel

• Surgeon
• Anesthesiologist
• Surgical Nurses
• Physician Assistants or Surgical Technicians

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma formation
• Recurrence of the hernia
• Nerve damage leading to chronic pain
• Risks associated with anesthesia

Benefits

• Relief from hernia-related pain and discomfort.
• Prevention of further complications such as bowel obstruction or strangulation.
• Improved quality of life and physical function.

Recovery

• Post-procedure monitoring in a recovery room.
• Pain management with prescribed medications.
• Instructions to avoid heavy lifting or strenuous activities for several weeks.
• Follow-up appointments for wound inspection and to monitor recovery.
• Gradual return to normal activities as advised by the healthcare provider.

Alternatives

• Watchful waiting for less severe, asymptomatic hernias.
• Non-surgical options like wearing a supportive truss, though these are typically temporary and not curative.
• Pros: Avoids immediate surgical risks.
• Cons: Risk of hernia becoming incarcerated or strangulated, requiring emergency surgery.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel anything. Post-operatively, there may be discomfort or pain at the incision site, which will be managed with pain medications. Initial rest, followed by gradual increase in activity as advised, is important for recovery.