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Laparoscopy, surgical; repair recurrent inguinal hernia

CPT4 code

Name of the Procedure:

Laparoscopy, surgical; repair recurrent inguinal hernia. Common name: Laparoscopic inguinal hernia repair.

Summary

Laparoscopic inguinal hernia repair is a minimally invasive surgical procedure used to fix a recurrent hernia in the groin area. This procedure involves making small incisions and using a camera to guide the repair of the hernia.

Purpose

The procedure addresses recurrent inguinal hernias, which are bulges in the groin area that occur when tissue or part of the intestine protrudes through a weak spot in the abdominal muscles. The goals are to securely repair the hernia, relieve discomfort, and prevent future recurrences.

Indications

  • Persistent pain or discomfort in the groin area.
  • Noticeable bulge in the groin, especially with activity or straining.
  • Previous history of inguinal hernia and surgical repair.
  • Symptoms such as nausea, vomiting, or bowel obstruction.

Preparation

  • Fasting for at least 8 hours prior to the procedure.
  • Adjustments to medications, particularly blood thinners.
  • Preoperative physical examination and imaging tests, such as ultrasound or CT scan.
  • Clear bowel regimen may be needed in some cases.

Procedure Description

  1. The patient is given general anesthesia.
  2. Small incisions (usually three) are made in the lower abdomen.
  3. A laparoscope (a thin, lighted tube with a camera) is inserted through one of the incisions.
  4. Carbon dioxide gas is used to inflate the abdominal cavity to provide a better view.
  5. Surgical instruments are inserted through the other incisions to repair the hernia using mesh to reinforce the abdominal wall.
  6. The incisions are closed with sutures or surgical tape.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

This procedure is performed in a hospital operating room or an outpatient surgical center.

Personnel

  • Surgeon (specialized in laparoscopic or general surgery)
  • Anesthesiologist
  • Surgical nurses
  • Operating room technicians

Risks and Complications

Common risks:

  • Infection at the incision sites
  • Bleeding or hematoma
  • Pain or discomfort Rare risks:
  • Damage to surrounding organs or tissues
  • Recurrence of the hernia
  • Adverse reactions to anesthesia

Benefits

  • Less postoperative pain compared to open surgery
  • Shorter recovery time and quicker return to normal activities
  • Reduced risk of hernia recurrence

Recovery

  • Patients can often go home the same day or the next day.
  • Instructions include wound care, pain management, and activity restrictions.
  • Avoid heavy lifting for at least a few weeks.
  • Follow-up appointment with the surgeon in about 1-2 weeks.

Alternatives

  • Open hernia repair surgery, which involves a larger incision.
    • Pros: May be more suitable for complex or very large hernias.
    • Cons: Longer recovery time, more postoperative pain.
  • Watchful waiting for asymptomatic hernias.
    • Pros: Avoids surgical risks.
    • Cons: Risk of hernia becoming symptomatic or complicated over time.

Patient Experience

During the procedure:

  • The patient will be under general anesthesia and will not feel any pain or be aware of the surgery. After the procedure:
  • Mild to moderate pain or discomfort at incision sites.
  • Possible grogginess from anesthesia.
  • Pain management with prescribed medications.
  • Most patients feel well enough to resume light activities within a few days.

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