HERNIA REPAIR

What is a Hernia?

A hernia is an abnormal opening in the muscle wall where part of the intestine bulges through. The most common hernias are inguinal and femoral hernias in the groin, and umbilical and incisional hernia of the abdominal wall.

• Femoral hernias occur when a loop of intestine escapes into the femoral canal (the passage of large arteries and veins in the leg leading to the groin) because of a weakness.

• Inguinal hernias occur when a weakness develops in the inguinal canal, sometimes with bowel protruding into the male scrotum or female labia.

• Umbilical hernias occur when bowel protrudes through a weakness in the abdominal wall around the navel.

• Incisional and Ventral Incisional hernias involve similar surgical procedures. An incisional hernia involves repair of a hernia related to an incompletely-healed surgical wound (e.g. previous abdominal exploratory surgery) while a ventral hernia requires repairing of bulging tissues through an opening in the muscles on the abdomen.

Who will need the surgery?

• Obstruction - A loop of the bowel becomes blocked so that solids cannot pass, or

• Strangulation - A part of the bowel becomes twisted, causing a blockage which cuts off blood supply and causes the bowel to become gangrenous or die.

What happens during the operation?

You may be given a general anaesthetic or have an epidural/spinal anaesthetic which numbs the operation site. Your anaesthetist will discuss these options with you.

The surgeon will make a five to ten centimetre cut at the site of the hernia. In some cases you may have keyhole (laparoscopic) surgery which means you have multiple small cuts to facilitate a camera and long laparoscopic instruments.  The intestine and abdominal tissue sitting in the hernial sac is then pushed back into place. Some “mesh” (a fine piece of netting) may be inserted for support and the cut is closed with a stitch which will dissolve and therefore does not need to be removed. The mesh provides a framework for the body to heal and scar to preventing recurrence of the hernia.

You will recover from the operation in the Recovery Room. You will remain in hospital for one night after your surgery (depending on your type of hernia) and if authorised by the surgical team, will be offered a light diet in the evening after your operation.

What to expect after your operation

·         Your doctor will visit you the morning after your operation and check that you are well enough to go home.

·         If you have a drain tube, a nurse will be instructed to remove it.

·         Once discharged from hospital you should go home and rest.

·         You may continue to experience wound pain. In fact it is normal to still have pain for a few weeks. If so, take pain relief tablets as prescribed upon discharge.

·         You will be sent home with dressing over your incision(s). These dressings should be removed three days after your operation. However, if blood starts to collect under the dressing(s), remove it (or them) and  then gently wash and dry the area. Do not cover the area again.

·         It is normal to expect bruising around the area and some swelling. For patients who have an inguinal hernia repair, your groin area may become quite swollen and it is important to wear supportive underpants.

For 24 hours after your operation:

·         Do not drink alcoholic beverages

·         Do not sign any legal documents

·         Do not use public transport without an escort

For 2 months after your operation:

·      Do not do any heavy lifting and avoid rigorous exercise as this may lead to a recurrence of your hernia

You will be seen by the surgeons in the outpatient clinic several weeks following your operation to check on your progress and healing.

This information is intended as a guideline only. If you have any further questions or concerns, please ask your doctor.