Hernia Surgery

Overview

Hernias can occur in multiple locations in your body. A hernia occurs when an organ, intestine or fatty tissue squeezes through a hole or a weak spot in the surrounding muscle or connective tissue. Hernias often occur at the abdominal wall. Sometimes a hernia can be visible as an external bulge particularly when straining or bearing down. These can frequently be reduced back where they belong, however sometimes that can become incarcerated and require more urgent surgery.

Causes of Hernias

Most hernias are caused by a combination of pressure and an opening or weakness of muscle or connective tissue. The pressure pushes an organ or tissue through the opening or weak spot. Sometimes the muscle weakness is present at birth but more often it occurs later in life. Anything that causes an increase in abdominal pressure can cause a hernia, including obesity, lifting heavy objects, diarrhea or constipation, or persistent coughing or sneezing. Poor nutrition, smoking, and overexertion can weaken muscles and contribute to the likelihood of a hernia.

More Information on Hernias

Inguinal Hernia

These hernias fall into Indirect (most common), Direct, and Femoral. They are typically repaired with mesh to reduce the recurrence

Umbilical Hernia

Located at the belly button, they can contain fat or bowel. They are typically small and can be repaired with mesh or primarily with a suture.

Ventral Hernia

Ventral hernias can occur after prior surgical procedures and are the result in poor healing

Non-Surgical Options

Only 3% to 5% of hernias will require emergency treatment for bowel obstruction and strangulation of trapped organs. Scheduled (that is, non-emergency) surgical treatment will eventually be required in 30% to 65% of hernias.2 If your hernia is not symptomatic, or if you have significant risks for surgery, your surgeon will monitor the hernia and make sure that it is not getting larger or causing problems. The use of abdominal binders and trusses may help minimize your symptoms by keeping the hernia flat.

Surgical Options

Laparoscopic repair - The surgeon makes several small incisions in the abdomen that allow surgical tools into the openings to repair the hernia. Laparoscopic surgery can be performed with or without surgical mesh.
Robotic repair - Like laparoscopic surgery, robotic surgery requires small incisions to repair your hernia. Robotic assisted surgical devices may offer ergonomic benefits for the operating surgeon and technological advances to include motion-scaling, tremor reduction and improved optics including surgeon control of the camera.
Open Repair - The surgeon makes an incision near the hernia and the weak muscle area is repaired. Open repair can be done with or without surgical mesh. Open repair that uses sutures (stitches) without mesh is referred to as primary closure. Primary closure is commonly used to repair inguinal hernias in infants, small hernias, strangulated or infected hernias.

AFTER SURGERY

AFTER YOUR SURGERY:

Keep your wound dry for 24-48 hours depending on what your surgeon says. The dressing that is in place is a usually waterproof. After 2 days, remove the dressing. At this time you may get the incision wet in the shower. Do not submerge your incision in water for one week from the time of your surgery. Leave the dressings off after 48 hours
It is usually helpful to use an ice pack on the region of your surgery for the first 24 hours after surgery, or an ice pack 3-5 times per day for 30 minutes for the four days after surgery.
You will be given a prescription for pain medication and are encouraged to use this medication as directed. This will help minimize your post-operative pain and allow you to remain active.
Please notify my office of excessive redness, drainage, swelling or bruising at the site of your incision. It is not uncommon to have swelling of the scrotum or penis.
Please make an appointment to be seen in the office approximately 7-14 days from the time of your surgery to have your wound checked.
Do not hesitate to take an over-the-counter laxative for the first week after surgery. Acceptable agents are Dulcolax tablets, Milk of Magnesia and Metamucil. Many other over-the -counter agents are also safe and effective. Please use your own discretion. Constipation is common after an inguinal hernia repair, and also may be worsened by pain medications.

ACTIVITY:

Driving vehicles: for the first few days after surgery we discourage driving except in emergencies. We give no specific time when driving may commence. We asked that you exercise common sense and make sure that you are safe time the wheel.
Sitting: for several days after surgery sitting may be uncomfortable. You may have to get up and move around and change positions periodically.
Stairs: no limitations
Lifting: for the first week lifting is limited to 10 pounds. This is gradually increased to 20 pounds at 14 days with unrestricted lifting after 30 days.
Return to work, school, and housework: generally resume limited activities in about seven days. Full duties may be resumed after 14 days.
Walking: generally you can resume walking as much as you feel comfortable walking starting the day after surgery. There is no specific limitation.
Impact sports: Generally start activities such as jogging or aerobics no sooner than two weeks. Without discussing specific activities if you feel like doing it give it a try however remember to listen to your body. If it hurts stop doing it and try it again a few days later.
Sex: began cautiously, no sooner than seven days after surgery. If it hurts then stop

WOUND CARE:

Support: men will usually be more comfortable after groin hernia surgery wearing support underwear such as jockey shorts to support the testicle which may be temporarily sore and swollen.
Dressing changes: remove the dressing at about 48 hours after surgery. Do not use antiseptics, peroxide or ointments. Do not disturb the skin strips. Placing another dressing on the wound is optional. It may be necessary if there is some drainage.
Bath/shower: you may get in the shower after 48 hours. Do not submerse the wound underwater for one week after surgery.
Wound symptoms: notify us if there is increasing soreness, swelling, drainage or redness of the wound.

DIET:

General: there are no specific dietary restrictions
Bulk and roughage: bran or Metamucil may be helpful in avoiding constipation

MEDICATION:

Pain: you will be given prescriptions for pain medication. You should have this filled and take it as directed. If you feel that you no longer need the prescription pain medication then the usual doses of Tylenol or Advil or aspirin can be used.
Sleep: over-the-counter Benadryl 25 to 50 milligrams at bedtime is usually enough. If not call us.
Laxatives: over-the-counter laxatives such as milk of Magnesia, mineral oil Metamucil etc. are acceptable. Try not to go over 72 hours without having a bowel movement.
Other medications: resume all the medications that you were on prior to surgery.

MISCELLANEOUS

After surgery you will be much weaker, more forgetful and less peppy than you expect. Do not be alarmed. This is normal and will improve over the next few weeks to few months.
If you have been sent home with elastic stockings continue to wear them until you are active and out of bed at least eight hours per day.
Check your oral temperature every evening.
Call us if:

The wound is more swollen, sore or read or there is increasing drainage requiring dressing changes.
Your temperature is over 101 degrees Fahrenheit within 24 hours after surgery
Most hernia repairs will have some discomfort for up to six months after surgery.
You have questions about this or anything else
If you have problems emptying your bladder

MISCELLANEOUS

You should already have an appointment for your first postoperative visit approximately one week from the date of your surgery. If you do not have an appointment please call to make one.

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