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Hernia Repairs
 

Hernia Repair:Information for patients

What is a hernia?

A hernia forms when there is a weakness in the muscle of the stomach wall. It shows itself as a lump in the groin. This lump usually becomes more noticeable during the day and with activity. It generally settles down over night. Sometimes when the lump is more noticeable it will cause some discomfort.

Why should I have my hernia repaired?

A hernia can cause you discomfort, particularly when you are lifting. Very rarely a hernia that has been causing you symptoms will become "stuck out" (strangulated); this is a serious, but a rare problem and needs an urgent operation.

After a hernia operation you are bound to feel some discomfort in the short term and in some people this can be a long-lasting and troublesome problem .

It is important to compare the symptoms that you have from your hernia with any problem you may get from the operation and after. We will help you to balance these risks.

How is a hernia repaired?

Hernias can be are repaired by strengthening the weakness in the muscle with a sheet of artificial mesh. This will then stay permanently in the body where it does no harm. It will continue to support the muscle. The mesh is usually inserted via a small cut in the groin.

The operation is often performed as a day case - you are able to go home on the day of operation.

Less often, for medical reasons or because of home circumstances, the operation will be done as an in-patient - you can usually go home on the day after the operation.

Occasionally patients who expect to go home on the day of surgery will need to stay in overnight.


Open hernia repair

Hernia Repair: Information for patients

With some patients, particularly if the hernia has been repaired in the past or if there is a hernia in each groin, the repair can be performed using key-hole techniques. if you would like to discuss key-hole surgery , we will be able to give you further information. The hernia is repaired in much the same way as with an open operation, but through a number of small cuts rather than through one larger cut. A mesh of artificial material is put into the abdomen to prevent the hernia from coming out again.


Key-hole hernia repair

What problems can arise after operation

Hernia repair operation  

The risk

What happens

What can be done about it

 

Infection

A wound may become infected causing pain, redness and possibly discharge. The rate of risk is less than 1 in 10.

Infections are usually minor and are treated successfully with dressings and/or antibiotics

Bleeding into the wound

Bleeding into the groin to form a bruise (haematoma). Some bruising occurs after one in ten operations,

usually settles without any treatment. If the bruise is very large a second operation may be needed (this is rare).

 

The hernia recurs

The hernia comes back in about one to three per hundred people.

Further surgery for repair is required

Ongoing pain or discomfort in the groin

 

One of the small nerves in the groin can be cut or damaged causing burning or aching in the groin on about 1 in 50.

This is a difficult problem to treat and may require referral to the pain clinic.

Hernia Repair: Information for patients

Additional problems particular to the laparoscopic procedure

Risk What happens What can be done about it

Hernia at the wound site

A small hernia may form through one of the small cuts, this is rare - occurring in less than 1 in 50 operations

Hernias usually need to be repaired by further surgery.

Need for open surgery

Keyhole surgery may not work and open surgery is needed - less than 1 in 10

Open surgery needs a bigger cut in the abdomen and a longer stay in hospital

Damage to an internal structure

Rarely a piece of bowel or a blood vessel may be injured

Further surgery for repair will be required

Bands of scar tissue

Bands of scar tissue can form inside the abdomen that may cause bowel blockage

 

Further surgery for repair may be required

Alternative treatment

Left untreated a hernia will get larger and cause increased symptoms. There is at some time a risk of strangulation, when this rare complication may occur is entirely unpredictable.

A truss may be worn which applies support to the weak area. The truss does not cure the hernia and can be uncomfortable. It is not always effective.

On the day of operation

If your admission is at 8.00am in the morning you must not eat anything 6 hours before.
You may drink a non-milky drink up until 6.00am.

If you are coming in at 12.30pm you may have a light breakfast (tea and toast for example) at 6.30am, and a non-milky drink up until 10.30am.

It is advisable not to smoke or drink alcohol on the day before your operation.

When you arrive in hospital, you will be shown to a bed and asked to change into a hospital gown. The surgeon doing your operation will visit and introduce him or herself. They will ask you some questions and examine you. If you and they then agree to proceed with the operation you will be asked to sign a consent form and the operation will take place.

If you or the surgeon decides that the operation as planned should not occur then it would need to be cancelled or postponed. This would happen very rarely and you will obviously be fully involved and informed in this discussion.

Hernia Repair: Information for patients

Patients who have an uncomplicated hernia repair can go home within 24 hours after the operation. Most of the patients who have their operation performed in the day surgery unit will go home on the day of operation. When you wake up after the operation we would expect that you would have some pain. We will give you tablets to control any pain that you do have.

Please remember to hand in your discharge letter to your Doctor's surgery within the next few days. You do not need to make an appointment to see your Doctor. The letter will be of help should you have any problems after the operation.

We will give you some pain killing medication. Please use these up to the recommended dose if you have any pain.

The stitches used to close your groin wound will not require removal. You can remove the protective dressing after about 48 hours.

You may take a shallow bath or shower as you wish, but please avoid soaking in the bath until the wounds are fully healed (usually about a week after operation), as this may delay normal healing.

If you have any concerns about your wound because it is red, hot, swollen or painful you should feel free to seek advice.

Over the next few days gently mobilise, rest in the afternoon and very gradually do a little more each day. Essentially you can do what you like, but if it hurts, stop doing it.

Do not do any heavy lifting, gardening, sports etc for at least four weeks after the operation. Do not drive for about a week after the operation. When you feel ready try a short test drive on a quiet road. It is also advisable to check with your insurance company before driving to make sure they are happy for you to drive.

You can return to work as soon as you feel able - this is usually within two weeks with light duties, and full return to normal by three weeks.

If you need further advice please ask.

 
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