CHIEF COMPLAINT:Left inguinal 1. hernia

HISTORY OF PRESENT ILLNESS:Twenty-four year old who recently lifted a moderately heavy

object and felt pain in his left groin. Since then he has had sensation of something moving in and out of his groin.

PAST MEDICAL HISTORY:2. Osteomyelitis of the right pretibial area requiring wide

debridement and drainage. Asthma.

PAST SURGICAL HISTORY:Drainage of osteomyelitis.

ALLERGIES: No known drug allergies [allergic to dogs].

MEDICATIONS:None.

SOCIAL HISTORY:Patient used to smoke, but has quit. Rarely drinks alcohol.

PHYSICAL EXAMINATION:Patient is alert, fit appearing young man in no distress.

CHEST:Clear.

CARDIOVASCULAR: Regular rate and rhythm.

ABDOMEN:Soft. There is an easily 3.palpable irreducible left 4. inguinal

hernia. No right inguinal hernia. There is a well healed

pretibial scar on the right and the left extremity is without clubbing, 5.cyanosis or 6.edema.

IMPRESSION:

Symptomatic left inguinal hernia.

I have discussed in detail the 7.laparoscopic 8.preperitoneal operation and the open operation. I have given literature on the surgery. The patient has opted for the laparoscopic repair. I have described this as more likely to lead to rapid recovery, but less tested than the open repair. In rare cases either repair has led to chronic pain if nerves are impinged. This is rare, however.

PLAN: Laparoscopic inguinal hernia repair on the left. preoperative antibiotics, 9.intraoperative 10.pneumatic boots.