Hernia repair

[Hombre]

I have ET and need a repair for an inguinal hernia. Does anyone have any advice whether to have open or keyhole surgery? Any problems with bleeding or clotting? Thank you!

[Mazcd Partner MPNVoice]

Hi Hombre, you need to discuss these options with the team who will be carrying out the procedure and also with your haematologist. Best wishes, Maz

[hunter5582]

Definitely involve your MPN Care Team in any decision about surgery. Do not expect the surgeon to have any idea about how ET would affect the procedure. Most do not have this knowledge.

I have had 4 surgeries in the last couple of years. I always opt for the least intrusive procedure available. Any tissue damage or bleeding will trigger reactive thrombocytosis. This is normal and to be expected. Increased thrombocytosis increases risk of both thrombosis and hemorrhage post-surgically. That is why minimizing tissue damage and bleeding during surgery is important.

The MPN Specialist can give you the best guidance on ET and any surgery. It helps to have his doc contact the surgeon directly for consultation. It is best to be involved in the communication so you also know what you need to know.

Hope the procedure goes well.

[EPguy]

I had two inguinal hernia operations on the same place, the 1st 1970's vintage one failed. Both pre MPN so no experience on that part.

But if your Dr tells you either option is available, Dr is experienced at both, and Heam/MPN team agrees it's entirely your choice, the laparoscopic (keyhole) has advantages. I would choose it if I needed a 3rd. I had a light 2 inch scar from #1. That long term groin pain noted in the report below has also been an occasional issue for me. The newer procedure should involve less cutting and bleeding (you can confirm with Dr) so that would be a positive re MPN.

(May 2022) ncbi.nlm.nih.gov/books/NBK4...

<<As more experience has been gained with the laparoscopic techniques, it is now used for the repair of the primary/unilateral inguinal hernia[2]. Potential benefits of the laparoscopic approach include quicker postoperative recovery and possible decreased incidence of long-term groin pain[2].>>

[Wyebird]

Hi I echo Maz’s reply

[finlay2106]

Hi Hombre,

Definitely try and have your surgical team liaise with your haematology team and keep both informed. I am on low dose aspirin (I have PV) and had to stop taking this about 6 days before surgery. Other blood thinning medication may be affected similarly if you're on this so you must discuss this with the surgical team and get advice from your haemo team.

I had open hernia surgery last August which was redoing a keyhole repair done in 2007. The surgeon felt that because that side had already been done keyhole it had be open 2nd time round. For good measure I had to have the other side done this March which was keyhole because it was the first time. For me keyhole is better as recovery is quicker and is less uncomfortable (although open wasn't that bad). The open surgery affected me for longer, mainly due to having to be very careful getting in and out of bed or a car. I would have thought the surgeon would be deciding which method to use but I think nowadays it's keyhole by preference. I would also advise, if you're able to influence this, to go with someone who has a fair bit of experience doing hernia repairs. I've had no after effects from either method once everything settled down. If you are on aspirin then avoid ibuprofen pain relief afterwards.

Good luck

Paul

[abuf]

Hi there,

I had two inguinal hernia surgeries on same site, first laparoscopic (keyhole), the second one open - repair of the first one (which unfortunately failed after cca 3 years). Both surgeries were done while I was having a platelet count of about 800.000, being only on baby aspirin. The haem only advised Clexane injectionone day before and couple of days after the surgery and stopping the aspirin few days before the surgery. Also, I remember I was given compression socks to wear during and after the surgery, for some days. The recovery was fast and uneventful after both surgeries (albeit the open one required a bit more time until I was fully back on track).

Good luck,

Vlad