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What happened during my surgery? Opinions welcome.
Hi All
This my first post, I’m hoping to benefit from the collective expert knowledge on this forum. There is a lot more information I can go into in subsequent posts if people may find it useful but I thought if I give out the bare bones of my surgery hopefully I won’t colour anyone’s opinions – I’m really interested in other people’s unprejudiced theories of the case. If anyone chooses to give an opinion on what happened – thank you.
I am in the UK and the operation was done on the NHS. I’m male, 50 and in good physical health – tall and slim. Very physically active – before surgery.
I was diagnosed with a right side indirect inguinal and diagnosed again by the operating surgeon approx 6 months after initial diagnosis. Around 7 months later I had TEPP. Bard 3Dmax. In my cubical straight after surgery, coming round from the general, still in gown.. oohhh.. let’s see this nice new flat groin. Felt my groin, lump was still there. WTF. Surgeon did his rounds before we were discharged. I told the surgeon about still having lump he just said seroma and did not examine me. I just accepted what he said (I was just a normal person back then before becoming a self-taught herniac.. remember those innocent times folks?) and went home. Over the coming days I was becoming more concerned about seroma diagnosis. Called hospital a week later, told by nurse it will be a seroma, not to worry and surgeon will not see me for 3 months. She said call back in a few weeks if still worried. Slow recovery for next couple of weeks. Called the hospital week 5 as was sure it was hernia and got an appointment with surgeon. During an appointment that week he located pubic tubercle and said that clinically I have a femoral hernia and not a seroma. Clinical Femoral diagnosis was confirmed a couple of months later by 2nd opinion surgeon (below and lateral to PT)
So.. there’s a whole lot more to this story.. unfortunately.. however based on the events above what are people’s thoughts on what may have happened?
Thank you all and may your pains be bearable 🙂
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8 Replies
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Femoral hernia repair is part of the laparoscopic repair. The mesh covers the femoral space. It would be odd to have a new femoral hernia unless it was completely missed and not taken down during the operation. That said, if it were missed, the mesh would entrap it, so it shouldn’t reduce easily. The story doesn’t sound right. Unless the mesh is not appropriately covering the area from the start.
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When I said the hernia reduces.. that was sloppy language. It can reduce in size when lying etc but I don’t believe it ever fully reduces as you can still feel a small lump. It’s far too painful to try and reduce it anyway. I feel like the mesh may be partly covering the femoral canal as my hernia lump has been slightly smaller since surgery. Can I contact you directly and maybe we could into more detail on a zoom consult? Thanks Keith
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Please contact my office directly if you would like a consultation. [email protected]
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Apologies for not getting back sooner. I have an appointment with Mr Professor Dr Alli Sheen (I just watched your convo with him) this Thursday so hopefully he maybe able to help me. I’ll post here if there is any information that may be helpful to others.
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It’s not expected to have a lump within hours after surgery. Usually seroma/hematoma takes at least some hours to develop. So, the differential diagnosis for a lump can be retained spermatic cord lipoma. Missed femoral hernia is less common for laparoscopic repairs and in males.
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Hi Doc
Just to clarify, same lump was present before and after surgery – it reduces etc. My guess would be that the femoral reduced during preperitoneal inflation and so was not noticed.
I just think I was misdiagnosed. Pubic tubercle never located in pre-surgery exams. I guess with femoral hernias being rare in males the surgeon lazily assumed inguinal and then placed the mesh further up the abdomen behind the deep inguinal ring.
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Laparoscopy usually causes significant swelling in the first few days afterward. Very odd that your swelling was so minimal that you could still feel the original lump. Also strange that the surgeon diagnosed the femoral hernia by feel. My understanding is that femoral hernias are hard to diagnose that way.
You’ve only mentioned the lump. What about the pain from the hernia itself?
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Hi GI
At the time of surgery my body fat % was probs around 15%, there was swelling around the groin and assumed mesh location. Guessing between 6 – 10mm of uniform swelling so my hernia (brazil nut size under skin etc) was very noticeable.
Femoral hernia was diagnosed 5 weeks after the surgery (same lump that was there on there straight after surgery) and I believe it being lateral and below pubic tubercle is pretty conclusive.
Pain? For the first recovery period? For the first 5 weeks before femoral diagnosis, it was not great. Lot of stingy aching at the mesh site and seemed slow to improve. In week 5, 3 days before being examined, pain was mostly gone. The pain since that exam.. wow.. that’s another topic all in itself.
Thanks for the link – I couldn’t agree more that femoral/inguinal need better differentiating.
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