A hernia is a protrusion of an organ or soft tissue of an organ through the cavity that normally contains it. The types of abdominal hernias include direct inguinal, indirect inguinal, femoral, umbilical, incisional, diaphragmatic, hiatal, Richter's, and Spigelian. The procedure to repair these types of hernias can be either an open or a laparoscopic surgery. Laparoscopy is a surgical technique where the surgeon inserts a camera and small devices into the abdomen to perform the surgery through many small incisions rather than a large incision. Open surgery allows for direct visualization of the hernia and its repair.
Recurrence of the hernia is the most common long-term complication of hernia surgery according to Dr. Tim Bax's writing for "American Family Physician." The hernia can recur at any time during the post-operative phase due to breakdown of the repair, defective mesh, patient's returning to physical activity too quickly or systemic diseases that impair wound healing. Common systemic diseases that impair wound healing include obesity, diabetes, steroid use and chronic obstructive pulmonary disease.
A very serious side effect of hernia surgery is a wound infection. Many steps are taken preoperatively to try to avoid this complication including thorough skin preparation prior to surgery and surgical antibiotic prophylaxis. Patients are instructed to keep the incision site clean and dry. Even when all the proper steps are taken to prevent infection, infections still can occur. The treatment for wound infection is often opening up the incision site to allow for drainage and antibiotics.
Post-operative bleeding from the incision site can be a potential complication of surgery. This is more common with open surgery than with laparoscopic surgery due to the size of the incision. Surgeons use a variety of techniques in the operative room to acheive hemostatis or control of bleeding. These techniques include electrocautery, direct pressure, tying off bleeding vessels and a variety of products that help increase blood clotting such as Surgicel.
Injury to Bowel
Hernias can contain loops of bowel, known as incarceration, that cannot be reduced back into the abdomen prior to surgery according to the Mayo Clinic. Sometimes the bowel can become strangulated when incarcerated and have its blood supply cut off. Strangulated hernias may lead to bowel necrosis or death. The treatment for these hernias may be a bowel resection.
Neurovascular and Organ Injury
Injuries to nerves, organs and blood vessels can occur during any surgery. The site where the surgery will be performed will have a risk of damage to the specific neurovascular structures or organs near the site. For example, inguinal hernia surgery can result in damage to the structures in the spermatic cord that are attached to the testicle.
A post-operative ileus is a condition of temporary absence of normal bowel function according to Merck.com. The condition can arise from direct manipulation of the bowel during surgery or from medications. The symptoms include bloating, vomiting, constipation, loss of appetite, lack of flatus and cramping. Ileus usually arises between 24 to 72 hours post-operatively. The symptoms usually resolve with bowel rest and intravenous fluids