Hernia Surgery Risks in an 88yr old Woman

[leahcanada]

FIrst I want to say thank you from the bottom of my heart. I have been writing on this forum regarding my dear Grandmother who has been suffering from left groin pain for 24yrs!!! Based on your guidance on diagnostic procedures she just had an Ultra Sound done correctly which showed a left femoral hernia. Never thought a hernia diagnosis would feel like winning the lottery but surely that is the way we feel.

The surgeon recommends surgery. He does not do it laporoscopically and says this has fallen by the way side because it is a lot more precise to do it with an open method. He would use a spinal. We worry about the risks vs the benefits. My grandma has debilitating groin pain so really wanted the surgery but is really worried about having a surgery since she is 88yo. Are their quite severe risks of not having it fixed and instead running the risk of strangulation. How severe can strangulation be? Any advice or guidance would be greatly appreciated. Thanks so much.

[sngoldstein]

Hernia Surgery Risks in an 88yr old Woman

Unless her health is too poor to tolerate a relatively minor operation, she should get it fixed. Femoral hernias in elderly women are at significant risk of strangulation, which can be a big deal. I do not agree that laparoscopic repair is in any way outdated but open under local or spinal may be safer in this case. Find an experienced surgeon who can give you a detailed explanation of the risks and benefits of the various approaches so you can make a proper informed decision.

[drtowfigh]

Hernia Surgery Risks in an 88yr old Woman

A femoral hernia can be repaired under local anesthesia with some sedation. It is worth repairing especially in a symptomatic patient. The risk of not repairing such a hernia is very high in terms of complications and includes death. â…“ of patients who end up requiring surgery for femoral hernia need it done emergently and among those â…“, 10% do not survive due to complications from bowel strangulation, infection, etc. That is a very very high number. It is best to repair the femoral hernia non-emergently, that is, under controlled elective manner. The assumption is that the patient is healthy enough to undergo repair with less risk for surgery.

I do not recommend laparoscopy for most patients who are 88 years old, even if it is theoretically a superior repair than the open repair especially for femoral hernias. It is not worth the risks of the repair, such as need for general anesthesia.

[leahcanada]

Hernia Surgery Risks in an 88yr old Woman

At first my grandma was to stay over night after her surgery but now it is just scheduled as a day surgery under spinal anesthesia. What especially should we look for regarding postop complications as well as how to prevent postop complications. Thanks!!

[drtowfigh]

Hernia Surgery Risks in an 88yr old Woman

Surgical site infection is always a concern. I recommend showering with soap or antibacterial agent (Hibiclens) the night before and the day of surgery.
Make sure she does not have a uronary infection or other infection at the time of surgery.
Blood clots in the legs are dangerous and risky after surgery. Walking a lot before and after surgery will help reduce that.
Do not shave the groin area yourself. Leave it up to the surgeon to do it the same day of surgery.
Eat well. High protein diets tend to offer best healing nutrition. Also, can take extra Vitamin C and Zinc. That also helps with healing.
Take Arnica 12c three times a day starting a few days prior to surgery and continue after surgery. You will notice less bruising, swelling and pain. Let your surgeon know.

Good luck!

[leahcanada]

Hernia Surgery Risks in an 88yr old Woman

My grandma had the hernia repair and is doing great. Only two issues on post op day 3 are a sharp burning groin pain when she stands that improves once she walks around. Could this be from the graft? Is this something to be concerned about do you think?

[drtowfigh]

Hernia Surgery Risks in an 88yr old Woman

It’s too early to say. If it’s better with walking then that’s a good sign. The area is tighter than she was so it’s normal to feel pain when engaging the muscles such as to get up from a chair or out of bed.

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