Having Laparoscopic Inguinal Hernia Surgery: A Patient's Perspective
The Need for Laparoscopic Inguinal Hernia Surgery
Between Christmas and New Year's Day in 2019, I noticed a slight bulge in my right groin area. After it started hurting and burning at times when walking and moving, I decided it was best to see a doctor for a possible hernia diagnosis.
A surgeon at Bangkok Hospital in Udonthani, Thailand, confirmed my suspicion on January 7, 2020. After a physical examination, Dr. Chatchai was 90 percent certain that I had an inguinal hernia. At my insistence, however, I requested a lower abdominal ultrasound that clearly showed I had an approximate three-centimeter anterior abdominal wall defect at the right inguinal region.
In this article, I first define an inguinal hernia and how I probably sustained it. Next, I describe my laparoscopic inguinal hernia surgery on January 8, 2020, and my recovery from it.
What Is an Inguinal Hernia?
If the tissue or an organ such as fat or small intestine protrudes through a weak spot in the groin or inguinal canal structure causing the groin or scrotum to protrude and it retracts normally when lying down but bulges when standing or exerting force, it may be an inguinal hernia.
Anatomically speaking, the abdominal region is the area between the chest and hips. The lower abdominal wall is the inguinal region or groin. The inguinal canal travels through the abdominal wall and is the passageway from the abdomen to the genitals.
There are two types of inguinal hernias--indirect and direct. An indirect inguinal hernia is congenital and caused by a defect in the abdominal wall typically present since birth. A direct hernia, however, develops over time due to excessive force and is caused by a weakness in the abdominal muscles. Direct inguinal hernias are more common than indirect and found primarily in older men but sometimes in women.
In this article, I will be concerned with the direct inguinal hernia that I sustained.
How I Suffered an Inguinal Hernia
Around Christmas time 2019, I decided to water fruit trees in my backyard. Instead of hooking up hoses to do the watering, I filled a bucket with 20-25 kilograms of water and carried it a few yards from the back of my house to the trees. I did this a successive number of times for a few days.
Shortly later, I noticed a bulging in my right groin area while showering. At the same time, I felt some pain and a burning sensation when walking and moving around. At night while sleeping, the bulging subsided.
I am convinced that my right inguinal hernia was caused by my frequent heavy lifting of water with my right arm. At age 75, my inguinal area was not as strong as it was at age 70 when I could easily do this lifting.
How My Inguinal Hernia Was Diagnosed
I first suspected having an inguinal hernia when I saw a protrusion in my right groin area while showering. When touching the bulge, it felt like a round lump. Later, I noticed some pain and a burning sensation when walking and moving around.
After deciding not to wait a month to have my hernia diagnosed at a medical appointment in Bangkok, I saw a physician and surgeon at Bangkok Hospital in Udonthani, Thailand, on the morning of January 7, 2020.
Dr. Chatchai diagnosed my inguinal hernia by palpation. While I was coughing and exerting force on my lower abdomen, the doctor felt the protrusion through continuous contraction and relaxation.
After showing me pictures of hernias, Dr, Chatchai was 90 percent sure that I had a direct right inguinal hernia. Surgery was the only way to correct the hernia. His question to me then was whether I wanted to wait or have an operation immediately.
In response to my question about watchful waiting, the doctor cautioned that the tissue of the prolapsed organs would increase in volume and cause more pain as the gap of the hernia got bigger. There was also the danger of the hernia becoming strangulated if the blood supply to the hernia was blocked,
I then suggested having a lower abdominal ultrasound to completely confirm the existence of my inguinal hernia. The doctor agreed and I waited until 3:00 in the afternoon to have the ultrasound.
During my ultrasound, the radiologist could not initially see the inguinal hernia. After I stood up, however, and exerted force on my abdomen, the doctor finally saw my hernia which he described as a three-centimeter interior abdominal wall defect at the right inguinal region.
How I Prepared for Surgery
One hour following my ultrasound, I saw Dr. Chatchai again. He had a copy of my ultrasound report and asked when I wanted to have surgery. After I replied as soon as possible, Dr. Chatchai scheduled my operation for the next day, January 8, at 4:00 p.m. In preparation for the operation, I would have to fast after 6:00 a.m. on the eighth and have no water to drink. I would also have to check into the hospital at 8:00 a.m.
After arriving at the hospital a little after 8:00, I signed some consent forms. The hospital had already contacted my Blue Cross Blue Shield medical insurance company in the United States that guaranteed full payment of my operation and stay in the hospital for two nights.
Before being wheeled into my hospital room, I had to have an EKG and take a chest X-ray. I then entered a private hospital room on the fifth floor that had facilities for my wife who accompanied me.
After changing into a hospital gown, it took two nurses almost an hour to finally insert a catheter for an IV into my left arm and draw blood. The first nurse just couldn't find a vein in my left arm to draw blood. I also supplied a vial of urine for a urinalysis.
By the time my IV started running, it was about 11 a.m. I still, however, had five hours until the start of my surgery. Although I had a TV in the hospital room and my wife was present, the long wait was very boring.
Before being sent to surgery, a cardiologist and anesthesiologist visited me. The cardiologist listened to my heart and lungs and said that my EKG and chest x-ray were normal assuring that my heart and lungs could handle the surgery. My blood work was also normal. Next, an anesthesiologist reviewed my medical history, the medications I was now taking, and asked if I had any allergies. I had none. She told me that I would be given general anesthesia.
Finally, at 3:40 p.m., after I removed my watch and dentures as well as putting on an operating room OR cap, I was moved from my hospital room to an OR on the third floor. Upon entering the OR, I quickly felt that the temperature was very cool. After being transferred to a narrow gurney for the surgery, my lower body was strapped in and my left arm was secured to the gurney. Attached to the left arm was an IV. Blood pressure and heart monitoring equipment were attached to my right arm with the results seen on a monitor. There were numerous lights above me and other monitors to my right.
What Is Laparoscopic Inguinal Hernia Surgery?
Laparoscopic inguinal hernia surgery is a technique to fix tears in the abdominal wall muscle using small incisions, a high-resolution camera at the end of a lighted tube, and a patch or mesh.
During laparoscopic inguinal hernia surgery, a small incision usually 1/4 to 1/2 inch is made in or below the navel. The abdomen is then inflated with carbon dioxide so the surgeon can see the abdominal organs. A thin lighted scope with a high-resolution camera in front called a laparoscope is then inserted through the naval incision. Instruments to repair the hernia are inserted through two other small incisions, one on each side of the navel. These instruments are held by the surgeon. After the hernia is repaired, a mesh is placed over the defect to reinforce the body wall. During this surgery, the patient is under general anesthesia.
My Laparoscopic Inguinal Hernia Surgery Experience
It seemed that I was lying down on the gurney in the OR for almost an hour before the surgeon, Dr. Chatchai, finally arrived. At around 4:40 p.m., the anesthesiologist put an oxygen mask over my face and instructed me to take two deep breaths. I was relieved to find out that I was not inhaling ether which I had had for surgeries when I was five and six years of age.
After taking the deep breaths, I became completely unconscious and didn't wake up until after the operation was over and the doctor was gone.
Upon coming after the operation, I felt like I had been hit by a train. As I was struggling to remove my oxygen mask, a nurse shouted that I should keep it on. As I was groaning in pain, the same nurse said that she would shortly give me a pain killer. In response to my question, the nurse said it was 7 p.m. and that I would soon be taken to my hospital room.
Recovering From My Surgery
I was wheeled from the OR to my hospital room a little after 7:00 a.m. My wife was waiting for me. After being transferred from a gurney to my hospital bed, an IV was started in my left arm. A blood pressure machine was placed on my right arm and took blood pressure readings every five minutes that night.
A nurse gave me some water to drink but instructed me not to eat anything or get up out of bed until the next morning. I had a bedpan for urination. Antibiotics and pain killers were administered intravenously.
After sleeping intermittently during the night, I was encouraged by a nurse to get out of bed and wash at about 6 a.m. I experienced no problems in the bathroom and then had a breakfast of boiled rice and fish delivered to the room. By this time, the blood pressure equipment had been removed from my arm and my blood pressure and temperature were now only taken every two hours.
I wasn't experiencing any pain but was having trouble passing gas. Perhaps this was due to the carbon dioxide that had been injected into my abdomen during the surgery.
Around noon on Thursday, the ninth, Dr. Chatchai stopped in and told me that the operation had gone well. The hernia was fixed and he showed me seven pictures taken by the laparoscope camera during the surgery. One of the pictures showed the mesh put over the defect in my abdominal wall muscle. Dr. Chatchai also changed the dressings on my three small abdominal incisions and remarked that I could get them wet while showering.
Before leaving, Dr, Chatchai felt it was alright for me to check out of the hospital and go home on Thursday afternoon. I decided, however, to stay in the hospital another night and make sure I had a bowel movement before being discharged. Besides, my insurance was paying for two nights in the hospital.
After a restful sleep Thursday night, Dr. Chatchai came to see me at 9:00 a.m. on Friday, the tenth. The doctor pronounced me fit to leave the hospital and said he was prescribing an antibiotic for me to take for five days and Paracetamol to take for pain if needed. Dr. Chatchai advised me to have light activity for the first two weeks following the operation and not to lift anything over one or two kilograms. He also cautioned me not to cough excessively or strain when having a bowel movement.
I checked out of Bangkok Hospital at 11:15 a.m. and returned on the 14th to have the stitches from my abdominal incisions removed. I have experienced no pain since the operation.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2020 Paul Richard Kuehn