Skip to main content

Postoperative Management

  • Chapter
  • First Online:
  • 1213 Accesses

Abstract

Inguinal hernia repair remains one of the most common surgical procedures performed by general surgeons throughout the world. While the vast majority of patients do well in the postoperative setting, there are various aspects of perioperative and postoperative care that, if managed appropriately, will help the patient through their recovery following repair. Given the potential for pain following hernia repair, a major focus of the perioperative and postoperative phases is pain management. Appropriate pain management and physical activity advancement allow the patient to resume their daily activities as well as employment, though activity advancement is quite varied from surgeon to surgeon. Other aspects of care, including fluid management and risk of urinary retention, can affect prompt discharge following inguinal hernia repair. While the majority of inguinal hernia repairs result in successful outcomes, there is potential for seroma, hematoma, infection, chronic groin pain, and recurrence, among other risks. While many of these risks can be treated nonoperatively, there is potential for prolonged convalescence and even reoperation, which can greatly affect the patient’s quality of life until resolved.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   54.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   99.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Mixter CG 3rd, Meeker LD, Gavin TJ. Preemptive pain control in patients having laparoscopic hernia repair: a comparison of ketorolac and ibuprofen. Arch Surg. 1998;133(4):432–7.

    PubMed  Google Scholar 

  2. Gobble RM, et al. Ketorolac does not increase perioperative bleeding: a meta-analysis of randomized controlled trials. Plast Reconstr Surg. 2014;133(3):741–55.

    Article  CAS  Google Scholar 

  3. Apfel CC, et al. Evidence-based analysis of risk factors for postoperative nausea and vomiting. Br J Anaesth. 2012;109(5):742–53.

    Article  CAS  Google Scholar 

  4. Apfel CC, et al. Volatile anaesthetics may be the main cause of early but not delayed postoperative vomiting: a randomized controlled trial of factorial design. Br J Anaesth. 2002;88(5):659–68.

    Article  CAS  Google Scholar 

  5. Apfel CC, et al. A factorial trial of six interventions for the prevention of postoperative nausea and vomiting. N Engl J Med. 2004;350(24):2441–51.

    Article  CAS  Google Scholar 

  6. Apfel CC, et al. A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers. Anesthesiology. 1999;91(3):693–700.

    Article  CAS  Google Scholar 

  7. Gonullu NN, et al. Prevention of postherniorrhaphy urinary retention with prazosin. Am Surg. 1999;65(1):55–8.

    CAS  PubMed  Google Scholar 

  8. Koch CA, Grinberg GG, Farley DR. Incidence and risk factors for urinary retention after endoscopic hernia repair. Am J Surg. 2006;191(3):381–5.

    Article  Google Scholar 

  9. Aeberhard P, et al. Prospective audit of laparoscopic totally extraperitoneal inguinal hernia repair: a multicenter study of the Swiss Association for Laparoscopic and Thoracoscopic Surgery (SALTC). Surg Endosc. 1999;13(11):1115–20.

    Article  CAS  Google Scholar 

  10. Dulucq JL, Wintringer P, Mahajna A. Laparoscopic totally extraperitoneal inguinal hernia repair: lessons learned from 3,100 hernia repairs over 15 years. Surg Endosc. 2009;23(3):482–6.

    Article  Google Scholar 

  11. Swadia ND. Laparoscopic totally extra-peritoneal inguinal hernia repair: 9 year's experience. Hernia. 2011;15(3):273–9.

    Article  CAS  Google Scholar 

  12. Baldini G, et al. Postoperative urinary retention: anesthetic and perioperative considerations. Anesthesiology. 2009;110(5):1139–57.

    Article  Google Scholar 

  13. Simons MP, et al. European hernia society guidelines on the treatment of inguinal hernia in adult patients. Hernia. 2009;13(4):343–403.

    Article  CAS  Google Scholar 

  14. Petros JG, et al. Factors influencing postoperative urinary retention in patients undergoing elective inguinal herniorrhaphy. Am J Surg. 1991;161(4):431–3; discussion 434.

    Article  CAS  Google Scholar 

  15. Hill MV, et al. Wide variation and excessive dosage of opioid prescriptions for common general surgical procedures. Ann Surg. 2016;

    Google Scholar 

  16. Schrenk P, et al. Prospective randomized trial comparing postoperative pain and return to physical activity after transabdominal preperitoneal, total preperitoneal or Shouldice technique for inguinal hernia repair. Br J Surg. 1996;83(11):1563–6.

    Article  CAS  Google Scholar 

  17. Bay-Nielsen M, et al. Convalescence after inguinal herniorrhaphy. Br J Surg. 2004;91(3):362–7.

    Article  CAS  Google Scholar 

  18. Bittner R, et al. Update of guidelines on laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia (international Endohernia Society). Surg Endosc. 2015;29(2):289–321.

    Article  CAS  Google Scholar 

  19. Hakeem A, Shanmugam V. Inguinodynia following Lichtenstein tension-free hernia repair: a review. World J Gastroenterol. 2011;17(14):1791–6.

    Article  Google Scholar 

  20. Bisgaard T, Bay-Nielsen M, Kehlet H. Re-recurrence after operation for recurrent inguinal hernia. A nationwide 8-year follow-up study on the role of type of repair. Ann Surg. 2008;247(4):707–11.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sean B. Orenstein .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Siegal, S.R., Orenstein, S.B. (2018). Postoperative Management. In: LaPinska, M., Blatnik, J. (eds) Surgical Principles in Inguinal Hernia Repair . Springer, Cham. https://doi.org/10.1007/978-3-319-92892-0_13

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-92892-0_13

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-92891-3

  • Online ISBN: 978-3-319-92892-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics