Inguinal Hernia - General or Urology?

Marie_LPN, RN, LPN, RN · Oct 15, 2005

Our general surgeons are the ones that do hernia repairs.

And it all depends on the pt.'s condition as to whether it's outpt. or not.

Corvette Guy · Oct 15, 2005

I am a first year student nurse doing clinicals on Med Surg. My husband finally got a job with insurance and we are finally addressing getting his inguinal hernia repaired!
I have to look over the list of covered docs...but I am not sure if we should be looking for a General Surgeon or a Urologist for this surgery? For some reason I am thinking that either can do it? :uhoh21:
I always thought hernia repair was more of an outpatient thing... but my past 2 pts in Med surg have been post op hernia cases...but they were incisional hernias and were open repairs, not lapo..so I guess that is why. One had JP drains, etc.
I am hoping he will be able to have a laparoscopic repair for a faster recovery. He absolutes HATES needles, IV's, anything related to hospitals, doctors, nurses, anything LOL. What he is dreading most actually is having to remove his contact lenses!
Well anyway, I appreciate any info on the direction to go in choosing a surgeon. I thought working on a med surg floor would be helpful in finding out about docs..but of course you never see them! LOL

Answer is General Surgeon

BTW, he will have to remove his contact lenses, as well as any body piercing jewelry. :chuckle

irshnrse · Oct 15, 2005

General surgeons handle inguinal hernia repairs whether inpt. or outpt. If, when the surgeon is operating, he sends something that requires a urological consult he will call one in the room. But, I worked in the PACU for 3yrs and never saw a urologist in on a inguinal hernia repair unless it was incarcerated. Good Luck!!

ianurse0509 · Oct 23, 2005

All of our inguinal hernias are done by general surgeons. Also, most of our procedures are not done laproscopic and are still done outpatient.

StokoRN · Oct 24, 2005

General surgeons do the inguinal hernias every place I have worked. Unless there is an odd complication, there is no involvement with the urinary track.

"Your flag decal won't get you into heaven anymore, it's already overcrowded from your dirty little war. Jesus don't like killin', no matter what's the reason for..." John Prine

The miracle is not that I finished. The miracle is that I had the courage to start.

FST66E · Nov 21, 2005

I have worked with urologists who do hernia repairs.

Go with the general surgeon!

shodobe · Nov 21, 2005

It can go either way. There are alot of urologists who have priviledges to do them. I personally would have a general surgeon do mine because there are more doing them laparoscopically and urologists have no clue how to do it this way. If you can look at the list of what surgeons can do, you would be amazed! Mike

Mommy TeleRN, RN · Nov 25, 2005

Thanks all! We saw a General Surgeon week before last who recommended a laparascopic mesh repair. He said it is rather large (thankfully though it's not bilateral!) and there is a risk he will have to go open, but he will just have to get in there and see if he can safely see all of it to repair.

We managed to get through pre-admit. My husband HATES needles and it was difficult to get the blood drawn. I had to use my therapeutic communication skills to talk him through it! The phlebotomist said he was for sure serious, she said when she saw his color change 5x she knew he meant he was really scared!

Now I just have to get him through the IV, that is what scares him the most. The surgery is Monday, he is first on the schedule. I just had my exam over peri-op in nursing school so I kind of have an idea of what to expect. How far will I be able to be there with him? Up until they wheel him off to surgery?

Also, in lecture they told us they give I think it's 2mg Versed to relax them before going in. Is that through the IV or an injection? If they could give him something before the IV that'd be great because I mean this man is DEATHLY afraid of needles.

At pre-admit he kept trying to walk out of the room saying "I can't do this, I can't do this" and I told him to sit down and BREATHE. I helped him focus on his breathing and rubbed his arm and hand (the side not getting poked) and had him focus on me while she did it (can ya tell I've been in labor a few times? haha)

Any other last minute advice? I know he is scared but I also know he will be glad to have it done. He is getting excited about being able to exercise again and get back in shape! He's had the hernia for oh, I think like 6 years and it's gotten really large, he can't wear jeans or anything so he is excited about getting to wear jeans again and not baggy athletic pants. I'm going to try and keep reminding him of the long term so he can get through the short term!

Mommy

shodobe · Nov 25, 2005

Even though they told him they would repair only the side that needed it, they will look at the other side and if necessary will repair that as well. This is all done through the same ports and does not need extra incisions. Every surgeon I have worked with always does this to keep patients from coming back a few years later to have the othe side done. It is no big deal. Good luck

Mommy TeleRN, RN · Nov 25, 2005

That makes sense Shodobe! If the right side was weak enough for a hernia, the left side may just be a matter of time.

Mommy TeleRN, RN · Dec 15, 2005

Just wanted to thank everyone for their advice. My DH got his surgery 2 weeks ago. Went pretty good. Doc said it was a "whopper" LOL they had a bit of problem getting the mesh in but doc was able to pull it off laparoscopically! yea!

He is recovering well although he developed a hematoma. The doc gave him 3 weeks for it to go down before they aspirate. Got DH off the caffiene and sodium and it's going down pretty good.

He is still on light duty for a few more weeks. But he is back to wearing jeans for the first time in about 5 years so he's very happy.

The nurses were WONDERFUL and even took time to show me extra things as they know Im a student. He was very worried about the IV but they injected a numbing med first and he didn't feel a thing! He broke into a HUGE grin immediately..wish I'd have had a camera it was hysterical!

I got through my finals and all is well! hehe Thanks again for pointing us in the right direction!