It has been determined that you have a FEMORAL HERNIA. Because of your current symptoms and/or physical findings, and the potential for complications arising from the presence of this hernia, surgical repair has been recommended. A Femoral Hernia occurs due to a weakness, gap or opening in the muscles, tendons or fascia of the lower abdominal wall at the bottom of the groin area (at or near the leg crease). This results in a bulge in the area consistint of intra-abdominal contents and/or pain or discomfort in this region. This pain and discomfort are the result of nerves in this area being irritated or stretched as the surrounding tissue is also stretched. If these hernias enlarge, intestine may become trapped within the hernia leading to intestinal blockage or damage (Incarceration or Strangulation). This is an emergency surgical situation.
Surgery involves repair of the area of weakness, and return of the abdominal contents back into their normal position. We utilize a plastic screen or mesh (usually made from non-reactive polypropylene) to reinforce the area in repairing the overwhelming majority of femoral hernias (both primary and recurrent hernias). The decision on which type, size and specific manufacturer of mesh to be utilized will be made by your surgeon at the time of surgery. Surgical repair of hernias is called a HERNIORRHAPHY. Since muscle is neither cut nor sewn together under tension, this technique is called a TENSION FREE REPAIR.
Most often in adults, surgery will be performed under local anesthesia. What this means is that although you are somewhat sedated and fully monitored by our Department of Anesthesia, you will not be put to sleep. Rather, the area will be numbed with the use of several injections of a Novocaine-like medication. You will be kept relaxed, comfortable and pain-free during the entire short procedure. After surgery, you will be observed in our ambulatory surgery center where you will be awake, active and able to walk. You will be offered a light snack as well. Most all patients are discharged on the day of surgery, Safely and Comfortably. A prescription for pain medication will be provided, or you will be instructed in taking over-the counter pain medication.
We have extensive experience in the repair of Femoral Hernias, performing numerous such repairs annually (and nearly 1000 hernia repairs overall annually). The surgeons of then North Penn Hernia Institute have received special training in hernia repair, and truly "Specialize" in this field of surgery. This permits us to provide you, our patients with the safest, most advanced and most effective hernia repair available. As such, our success rate is extremely high, equal to or better than the National Average. Additionally, our complication rate is extremely low, again comparable to or below that seen nationally.
So that you may be fully informed, as required by Pennsylvania law, we have listed below the possible major complications of hernia repair, including Femoral Hernia surgery, based on national averages. Again, we believe our success is better and our complication rate lower than these averages, but they are listed below for your information.
All surgical incisions may be associated with some local numbness, as virtually invisible nerves within the skin and lower layers are divided during the incision process., Most of this will be temporary, however a small area of residual numbness around the incision may persist. This is generally well tolerated, minimally noticeable and creates no functional problems. This mild numbness may be located in a small area of skin below the incision or incision or slightly into the scrotum (men) and upper thigh. Again, this is generally non-problematic, and frequently not noticeable.
- Recurrence of the Hernia...................About or Less Than 1/2% or 1 in 200 (first time repairs)
- This 1/2% recurrence (1 in 200 patients) occurs most often in either very obese patients or in those with large and/or long neglected hernias
- Infection of Incision.............................................................Less than 1/2% or 1 in 200
- Bleeding (fully controlled in OR)............................................Less than 1% or 1 in 100
- Swelling and Black/Blue(temporary and usually mild)..............About 5% or 1 in 20
- Actual or Perceived change in testicular size/function......................Less than 1%
- Injury to Bladder or Bowel or Vas Deferens..................................Extremely rare (less than 1/2% or less than 1 in 200)
- Numbness or Chronic Incisional Pain*........................................1-2%
(*Generally mild, non-debilitating and resolves over time)
Source: HERNIA, Nyhus & Condon, 5th Ed., 2002
Chronic incisional pain or discomfort occurs in approximately 1-2% of all hernia repair techniques. With our method this is generally mild and usually temporary, lasting 2-3 months. More chronic pain is less likely. Severe and long lasting pain at the area of the incision can occur, but is extremely rare (less than 1/2%).
If your hernia is being repaired for the second or more time, the chance of recurrence and other complications listed above are a bit higher, including infection and change in testicular size post operatively. We also have extensive experience in the repair of multi-recurrent and large hernias which have been especially referred to us. We will take every available precaution and use contemporary technique to reduce these complications for you
According to Law, I attest that I have read and fully understand the three (3) pages presented here, and I have been informed and understand the risks and complications associated with Femoral Hernia Repair, as well as the alternatives to surgery and the risks of non-operative management. I understand the nature of my problem, based on the discussion with my physicians and the above information. Additional questions I had have been answered to my satisfaction and I agree to the surgery as planned.