Name of the Procedure:

Repair Recurrent Femoral Hernia; Incarcerated or Strangulated

Summary

A surgical procedure to fix a femoral hernia that has reappeared and is trapped (incarcerated) or has its blood flow cut off (strangulated). The goal is to reposition the tissue and reinforce the area to prevent future hernias.

Purpose

This procedure addresses the recurrence of a femoral hernia, particularly when it becomes incarcerated or strangulated, leading to potential life-threatening complications. The primary goals include relieving pain, restoring normal anatomy, and preventing future hernias.

Indications

• Persistent groin pain and a noticeable lump
• A lump in the groin area that does not reduce when lying down
• Signs of bowel obstruction (e.g., nausea, vomiting, abdominal pain)
• Previous femoral hernia repair with recurrent symptoms
• Complications such as incarceration or strangulation

Preparation

• Fasting for at least 6-8 hours before surgery.
• Stopping certain medications as advised by the healthcare provider.
• Blood tests, imaging studies like an ultrasound or CT scan, and a thorough physical examination.

Procedure Description

1. The patient is given general anesthesia or regional anesthesia.
2. An incision is made near the location of the hernia.
3. The trapped or strangulated tissue is located and carefully repositioned.
4. Any damaged tissue is repaired.
5. The area is reinforced, often using a mesh to prevent recurrence.
6. The incision is closed with sutures.

Tools and technology include surgical instruments, possibly a laparoscope, and mesh materials.

Duration

The procedure typically takes 1 to 2 hours, depending on the complexity of the hernia.

Setting

Usually performed in a hospital operating room or a specialized surgical center.

Personnel

• Surgeon specialized in hernia repair
• Anesthesiologist
• Surgical nurses and technicians

Risks and Complications

• Infection and bleeding
• Recurrence of the hernia
• Damage to surrounding tissues or organs
• Complications related to anesthesia
• Chronic pain at the surgical site
• Bowel obstruction

Benefits

• Relief from pain and discomfort
• Prevention of further complications
• Restoration of normal function and activity levels
• Reduced risk of the hernia recurring when proper techniques and reinforcement materials are used

Recovery

• Pain management with prescribed medications
• Instructions for wound care and activity restrictions
• Most patients can return to light activities within a week but should avoid heavy lifting for 4-6 weeks
• Follow-up appointments to monitor recovery and ensure proper healing

Alternatives

• Watchful waiting in cases without severe symptoms
• Non-surgical methods (not typically effective for incarcerated or strangulated hernias)
• Different surgical techniques (open vs. laparoscopic), each with its own pros and cons

Patient Experience

Patients can expect some discomfort and pain post-procedure, managed with medications. They might feel tired and will be given guidance on how to manage their activities and wound care to ensure a smooth recovery. Regular follow-ups will help assess and document the healing process.