Para-umbilical hernia + operation risks:
- Establish if pt is competent to consent or not?
- Establish rapport
- Discuss options in family meeting
Describe the surgery for para-umbilical hernia repair?
- Identify hernia sac and content (& reduce contents)
- Herniotomy - excise sac and close defect
- +/- Herniorrhaphy - structural repair of abdominal wall
- +/- Resection of non-viable bowel
What are the risks of para-umbilical hernia repair surgery?
- General: bleeding, infection, reaction to GA, DVT/PE, MI/stroke
- Specific: pain, damage to bowel, recurrence (30%!!)
What are the alternatives to para-umbilical hernia repair surgery?
- Active conservative: NBM + NG tube, IV fluids/antibiotics, analgesia, DVT prophylaxis
- Palliation: comfort measures, inform family, NFR