Download Meridian Surgical Services, Inc

Robert C Wright, MD, PS– Puyallup, Washington
Informed Consent – Inguinal Hernia Repair
(right / left / both sides)
Your symptoms and physical exam suggest that you have an inguinal hernia. A hernia is a defect or rupture
in the normal abdominal wall. After careful consideration, an inguinal hernia repair has been recommended.
Risks of an Untreated Hernia
Inguinal hernia should be repaired soon after the hernia is detected. There is a possibility that abdominal
organs could get trapped in the hernia sac and become stuck (incarcerated) or worse, become twisted
(strangulated). This will require an emergency surgery, with possible severe complications. Secondly, the
hernia will not go away with time; it will only get bigger. There are no other adequate treatments for an
inguinal hernia.
Description of the Procedure
An inguinal herniorrhaphy is performed by making an incision in the skin above the groin over the opening
in the hernia sac, identifying the hernia sac; and then closing the hole (or rupture) in the abdominal wall.
Inguinal hernias can be of two types and the exact repair procedure depends on what type you have, and the
size of the defect.
Additional Procedures that may be performed at time of Surgery
It is impossible to predict all of the variations that may be encountered during an operation. The following
procedures may be performed in addition to the inguinal herniorrhaphy, if deemed necessary;
Mesh Placement - in many situations we recommend artificial mesh to buttress the hernia and prevent
recurrence. It also significantly reduces the amount of postoperative pain.
Femoral or Obturator herniorrhaphy - if found these should also be repaired.
Removal of a testicle or Hydrocele repair.
Alternatives for Treatment
At this time, there are no effective alternative treatments for an inguinal hernia. Laparoscopic hernia repair
techniques have been developed, with varying degrees of success. It is generally recommended for bilateral
or recurrent hernia repairs. Your surgeon may offer this technique for you if appropriate.
Benefits for Treatment
The overwhelming majority of people undergoing an inguinal hernia repair will not have the hernia recur.
The risks of avoiding repair outweigh the risks of surgery.
Risks/Complications of Treatment
Treatment risks fall into two categories; those that could happen during any operation under anesthesia, and
those that are specific for the hernia repair operation. In any medical treatment, it is impossible to predict all
the things that could go wrong. Fortunately, complications are the exception rather than the rule. Every
reasonable effort is made to avoid complications. The most common possible complications are as follows:
Possible complications following any operation
1. Bleeding - this is a problem that could happen anytime the skin is cut. The need for a blood
transfusion
during or after this operation is extremely rare.
2. Infection - we take special precautions to prevent an infection, but it is always a possibility. An
infection
is a special concern if a mesh is placed.
3. Reaction to medications - this could be many things, from a minor rash to possible death.
4. Reaction to anesthesia—this could show up as a heart attack, blood clots, pneumonia, sore throat, or
potential death, in rare cases.
5. Poor wound healing
(see other side)
Possible complications following hernia repair surgery
1. Hernia recurrence - a small percentage of patients will suffer a recurrence of their hernia, within
months or years after the repair. It will need to be repaired again.
2. Scrotal/Wound hematoma - occasionally a large bruise will form over the wound or into the scrotum.
If this is severe or happens right after surgery, reoperation may be required. Avoid aspirin to
minimize this risk.
3. Prolonged numbness/pain in the incisional area or scrotum - there are several nerves in the area of
the hernia defect. Despite careful operative technique, a patient may, on occasion, note prolonged
numbness or pain in the inguinal area from nerve injury or scar entrapment.
4. Testicular atrophy or sterility - the blood vessels and structures going to the testes are in the area of
the hernia defect. Once again, despite careful technique, these structures might get injured on rare
occasion.
5. Bowel or bladder injuries - these organs may lie immediately next to the hernia opening, or may
even be involved with the hernia sac. Should injury to these structures occur necessary steps will be
taken to repair the injury. It may necessary to have a second operation for this purpose.
Anticipated Recovery/Expected Rehabilitation
Recovery is quite variable, depending on the individual. You will recover faster if you begin walking on the
evening of surgery. For everyone’s safety, do not drive a motor vehicle or operate dangerous machines for a
week following surgery, while on narcotic pain medications. Also do not lift anything greater than fifteen
pounds for three weeks after surgery. You should then be restricted only from activities that cause
discomfort. This usually ends by six weeks following surgery.
Consent for Treatment
I understand my condition to be an inguinal hernia and am aware of its risks if untreated. I have read
and understand the above explanation of the procedure being proposed. My surgeon has answered my
questions, and I choose to proceed with surgery.
I understand that every operation may yield unexpected findings. I give the surgeon permission to act
on his best judgment in deciding to remove or biopsy tissues that appear to be diseased, understanding
that complications may arise from that action.
I understand that while most people receiving an inguinal hernia repair benefit from the operation, I
may not. My condition may not improve, and it may worsen. No absolute guarantee can be made.
HIPPA: Before and after surgery, unless otherwise requested in writing by you, visitors who you invite
to attend the surgery will be informed of the surgical finding, your surgical status, and anticipated
recovery issues for effectiveness of communications. Because of the anesthetic, you may or may not
remember these important details.
PRINT NAME OF PATIENT __________________________________________________________________
SIGNATURE __________________________________________________________ DATE _________________
WITNESS ____________________________________________________________ DATE _________________
SURGEON ____________________________________________________________ DATE _________________
RELATIONSHIP TO PATIENT IF SIGNATURE OF LEGAL GUARDIAN ___________________________________
I waive the right to read this form, and do not want to be educated and informed of treatment risks;
nonetheless, I understand the need for this surgery and grant permission to the surgeon to proceed on
my behalf.
SIGNATURE _______________________________________________ DATE _______________________
3/03