Hernia Surgery Options for Patients with Complex Health Issues

Q: Hernia Surgery Options for Patients with Complex Health Issues

Hello： In response to your questions. <br>1. <br>The surgical process imposes external stress on the body, which can trigger the onset of internal diseases. <br>For example, if your father has carotid artery blockage, it may increase the risk of a stroke. <br>It is advisable to h

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Dear Dr.
Hsu,
My father recently experienced lower abdominal bloating and pain while playing golf after standing for a while.
The doctor diagnosed him with a hernia and recommended surgery with a hospital stay of three days.
Is this considered traditional surgery?
Additionally, my father had been fainting frequently and had swelling in his body last year.
He was hospitalized and diagnosed with approximately 95% blockage in the right carotid artery (which extends to the brain's blood vessels), hypothyroidism (which has returned to normal levels after medication), and kidney issues leading to proteinuria.
Last week, he was hospitalized for three days of steroid treatment, which completely resolved the swelling, but his protein levels are still slightly low.
Given his current health status, is he suitable for surgery?
He is quite resistant to hospitalization, and I always hope he can trust the recommendations of medical professionals.
Are there any newer medical techniques available that would allow for same-day surgery, enabling him to return home after the anesthesia wears off?
Thank you in advance for your response!

Fanny, 30~39 year old female. Ask Date: 2005/03/30

Dr. Xu Wencang reply Urology

Hello: In response to your questions.
1.
The surgical process imposes external stress on the body, which can trigger the onset of internal diseases.
For example, if your father has carotid artery blockage, it may increase the risk of a stroke.
It is advisable to have a preoperative outpatient assessment to evaluate the surgical risks.
2.
Current adult hernia repair techniques can utilize specially designed mesh implants to prevent herniation.
If the severity of the hernia is not high, it can be performed under local anesthesia combined with mild sedation.
However, please note that under the current health insurance system, there may be out-of-pocket expenses.

Reply Date: 2005/03/30

More Info

When considering hernia surgery options for patients with complex health issues, such as your father's case, it's essential to evaluate both the type of hernia and the patient's overall health status. Your father's diagnosis of a hernia, particularly given his history of significant health issues, requires careful consideration of the surgical approach and the associated risks.

Types of Hernia Surgery
1. Open Surgery: This traditional method involves making a larger incision to access the hernia. It is often used for larger hernias or when there are complications. Recovery typically requires a hospital stay of several days, and the patient may experience more postoperative pain.

2. Laparoscopic Surgery: This minimally invasive technique uses small incisions and specialized instruments, including a camera. It generally results in less pain, shorter recovery time, and a quicker return to normal activities. Some patients can even go home the same day as the surgery.

Considerations for Your Father's Health
Given your father's complex medical history, including carotid artery blockage, hypothyroidism, and kidney issues, several factors must be considered:
- Surgical Risks: The presence of significant carotid artery blockage raises the risk of complications during surgery, such as stroke. His recent hospitalization for steroid treatment and the management of kidney function also indicate that his body is under stress, which could complicate recovery.

- Anesthesia Concerns: Patients with cardiovascular issues may have heightened risks associated with anesthesia. It’s crucial that the surgical team is aware of his full medical history to tailor the anesthesia plan accordingly.

- Postoperative Care: After surgery, patients often require monitoring for complications, especially if they have pre-existing health conditions. Your father's recent experiences with fluid retention and protein loss in urine suggest that he may need closer monitoring post-surgery.

Current Surgical Options
In recent years, advancements in surgical techniques have led to the development of outpatient procedures for hernia repair. Many facilities now offer laparoscopic hernia repairs that allow patients to go home the same day. This could be a suitable option for your father, provided his overall health permits it.

Recommendations
1. Consultation with a Specialist: It is vital for your father to have a thorough preoperative evaluation by a surgeon who specializes in hernia repairs, particularly one experienced in managing patients with complex health issues. This evaluation should include a review of his cardiovascular status and any other relevant health concerns.

2. Discussing Surgical Options: During the consultation, discuss the possibility of laparoscopic surgery versus open surgery. The surgeon can provide insights into which method would be safer and more effective given your father's health status.

3. Addressing Concerns about Hospitalization: If your father is resistant to hospitalization, it’s essential to communicate the importance of the procedure and the potential risks of not addressing the hernia. Emphasizing the benefits of a minimally invasive approach may help alleviate some of his concerns.

4. Postoperative Planning: If surgery is deemed appropriate, ensure that there is a clear postoperative care plan in place. This should include follow-up appointments to monitor his recovery and manage any potential complications.

Conclusion
In summary, while your father's hernia requires surgical intervention, the approach must be tailored to his unique health circumstances. Engaging with a qualified surgeon who can assess the risks and benefits of different surgical options is crucial. Minimally invasive techniques may offer a viable path forward, allowing for a quicker recovery and less time in the hospital. Always prioritize open communication with healthcare providers to ensure that your father's concerns are addressed and that he feels supported throughout the process.

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