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Para-umbilical hernia + operation risks:
Management steps?
- Establish if pt is competent to consent or not?
- Establish rapport
- Discuss options in family meeting
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Describe the surgery for para-umbilical hernia repair?
- GA
- Identify hernia sac and content (& reduce contents)
- Herniotomy - excise sac and close defect
- +/- Herniorrhaphy - structural repair of abdominal wall
- +/- Resection of non-viable bowel
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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%!!)
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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
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