What preoperative preparations are indicated in laparoscopic inguinal hernia repair?

Updated: Apr 16, 2020
  • Author: Danny A Sherwinter, MD; Chief Editor: Kurt E Roberts, MD  more...
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Answer

Special patient preparations are minimal for totally extraperitoneal (TEP) repair. Patients should not eat after midnight before the operation. Shaving the operative site before arrival at the hospital should be discouraged.

Informed consent should center on the alternatives to TEP and on potential complications, including recurrence. Patients should be aware that TEP requires general anesthesia, which carries its own attendant risks. An alternative is an anterior repair with local anesthesia.

There are several complications that are potentially severe in TEP but typically negligible in anterior repairs. Life-threatening hemorrhage due to major vascular injuries is possible. Entry into the peritoneum may occur during the procedure potentially resulting in visceral injury and adhesions.

Patients who are undergoing laparoscopic repairs should be educated regarding expected postoperative pain, possible temporary discoloration of the groin and scrotum, and seroma formation within the first few postoperative days. It is also important to discuss the possibility of nerve injury and chronic postoperative pain (defined as pain lasting longer than 6 months). Although this is an uncommon result, it can be highly frustrating to the patient and should therefore be addressed beforehand.

Patients undergoing a unilateral laparoscopic repair should be counseled on the possibility that bilateral hernia repair may be necessary if a contralateral hernia is encountered during surgery. Consent for this procedure should be obtained.


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