Cheltenham Vascular Unit

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Hernia Surgery
How is the hernia repaired?

Standard repair
Most hernias are repaired using open (standard) surgery. The hernia is repaired by making a cut in the skin over or near the hernia and the contents of the hernia are returned to their proper place. The weakness is repaired with stitches. Often a piece of plastic mesh is placed in between the layers of the body wall to help reinforce and strengthen the repair. The plastic mesh stays in place for life and should cause no problems.  Generally the skin stitch useed is dissolvable and will not need removing.

Laparoscopic repair
This technique is used mostly for inguinal hernias, and occasionally for other types of hernia. Laparoscopic surgery is often referred to as ‘keyhole surgery’ Very small cuts are made in the patient’s abdomen and a fine telescope (a laparoscope) and other specialised instruments are inserted through these cuts. Usually, a piece of synthetic mesh is used to close the hernia and stop the intestine pushing through the muscle wall again.

Which is the right one for me?
There are advantages and disadvantages for both types of repair. Your surgeon will discuss the options with you as appropriate.

The anaesthetic
The operation will usually be performed using either a general or local anaesthetic. A general anaesthetic means that you are asleep for the whole operation. All laparoscopic hernias are done under a general anaesthetic.
If you are having your operation under a local anaesthetic you will be awake during the operation although you may be given medication to make you slightly sleepy.  The local anaesthetic will be given by injection to the hernia site.  More local anaesthetic will be given as required throughout the operation.  The numbness may last for several hours after the operation. Occasionally a spinal anaesthetic is used. Your anaesthetist or surgeon will advise you on the type of anaesthetic to be used based on your general fitness, type of surgery, any other medical problems and your personal preference.
Side effects of hernia surgery
·The area may be bruised and discoloured after surgery. This will take several weeks to settle down. With inguinal hernia repair the bruising may spread to the scrotum. If the bruising or pain is very severe or you are unable to pass urine you should contact your GP immediately.
·You will experience pain and discomfort after the operation and painkillers may be necessary for the first few days or weeks. Guidance on painkillers will be given whilst you are in hospital.
·Recovery can take several weeks and you may feel tired for a period of time after your operation. It is important that you gradually build up your activity each day, as you feel up to it.
·Swelling behind the wound. This is normal and a hard ridge often persists for several months. However if there is a large swelling that concerns you at any time contact your GP.
·You may have areas of numbness or altered sensation around the wound. This usually improves over a few weeks but can be permanent.
·You will be left with a scar after surgery although this should fade over time. Most scars heal with a thin line but some are permanently wide or thick.

Risks and complications of hernia surgery
There is a risk of being left with permanent pain after hernia surgery. This appears to be more common after surgery for recurrent hernia repair. This chronic pain may require prolonged treatment.

2.Wound infections are uncommon but if you notice increasing redness, swelling or pain see your GP.  If you had a mesh put in and you develop an infection you may need to have the mesh removed to help clear the infection, but this is not always necessary.

3.There is a very small risk of damage to the blood vessels supplying the testicle in male patients undergoing inguinal hernia repair. The risk is higher, around 5% if the hernia has been operated on before. This can lead to swelling or shrinkage of the testicle and this can be permanent.

4.There is a minimal risk of developing blood clots in the legs after surgery (deep vein thrombosis).The blood clots can get dislodged from the legs and go to the lungs where they can cause pain and shortness of breath (pulmonary embolism).

5.As with any operation there is always a risk to heart and lungs because of the strain they are put under during the operation.  Death after hernia surgery is almost unheard of. However, no operation is completely free of risk.

Activity and discharge from hospital
Once you are independent and managing food and drinks, arrangements will be made for you to go home. Most patients go home the same day as the surgery.

Commonly asked Questions after hernia surgery
Will my hernia return?
Although uncommon there is a small risk that the hernia may return at some time. National figures suggest this occurs in about 2 in every 100 patients.

Will I do any harm by lifting?
You may not feel like lifting heavy objects for several weeks after surgery. You shouldn’t do any harm even lifting straight away but it would be wise to gradually increase the weight that you lift.

When can I drive again?
You can begin driving again once you can perform an emergency stop comfortably and without hesitation. This usually takes about 2 weeks.  Try it in a stationary car first.
It is advised that you inform your car insurance company that you have had an operation.

Will the operation affect my sex life?
Hernia surgery should not affect your sex life. You can return to normal sexual relations as soon as you feel comfortable.

When can I play sport again?
You may undertake physical activity including walking and playing sport as soon as you feel comfortable, but build up slowly.

When will the pain stop?
Twinges of pain are common even several months after surgery.

Follow up
Some surgeons make arrangements to see their hernia patients in the outpatient clinic after the operation and some do not.  If you have any difficulties or complications please contact your GP for advice. Sometimes your GP will then refer you back to the hospital if necessary.

Futher information
The information contained on this website is intended as a guide only, it is not intended to subtitute for medical consultation.
For further information please see your doctor.