Incisional Hernia Repair

Specific risks associated with this procedure:

• Damage to internal organs.
• Injury to the bowel.
• Developing a lump at the site of the original hernia.
• Difficulty passing urine.
• Unsightly scarring.

For male patients:

• Discomfort or pain in the testicle on the side of the operation.
• Damage to the blood supply of the testicles.

There is a small chance the hernia will come back, even many years later, so you may need another operation. This will depend on:

• The size of the hernia.
• The strength of your abdominal muscles.
• Whether you are overweight or have underlying medical problems.

If you are female, let your surgeon know if you are planning to become pregnant. Pregnancy increases the size of your abdomen and may undo the hernia repair.

There are a few things you can do before your procedure to make sure everything goes as smoothly as possible:

• Let your doctor know about any medication you take and follow their instructions.
• Stop smoking. Stopping in the lead-up to the procedure can help reduce your risk of complication.
• Try to maintain a healthy weight.
• Exercise regularly but do not do anything that involves heavy lifting or makes your hernia painful.
• In the week before the operation, do not shave or wax the area where a cut is likely to be made.
• Try to have a bath or shower either the day before or on the morning of the operation.
• If you are diabetic, keep your blood sugar levels under control around the time of your procedure.

This repair is usually performed under general anaesthetic and can take several hours. Laparoscopic (keyhole) surgery is associated with less pain and scarring than open surgery, as well as a faster return to normal activity. Your consultant will carefully assess you beforehand as in some cases, laparoscopic surgery cannot be performed, and you will need to have open surgery instead.

• Your surgeon will make a small cut on or near your belly button and insert an instrument to inflate your abdominal cavity with carbon dioxide.
• They will then make two more cuts on your abdomen so they can insert surgical instruments as well as a laparoscope (tiny telescope) via thin tubes.
• They will free up the structures from your abdomen that are stuck in the hernia and reinforce the area with surgical mesh and staples.
• They will close the cuts with stitches or glue.
• They may insert a tube in your wound to drain away any fluid.

You will either be given injections of local anaesthetic or medication to control the pain, which is important to allow you to move about and cough freely.

After keyhole surgery it is common to have some pain in your shoulders due to the small amount of carbon dioxide gas that may be left under your diaphragm. Your body will absorb the gas naturally over the next 24 hours, which will ease these symptoms.

You will be able to go home the same day and must arrange for someone to drive you.

For the first 24 hours:

• Someone should stay with you until the general anaesthetic has worn off.
• Do not drive, operate machinery, or do any potentially dangerous activities (like cooking) until you have fully recovered feeling, movement and co-ordination.
• Do not sign any legal documents or drink alcohol.
• Get plenty of rest but stay active to avoid blood clots.
• Follow the instructions from our healthcare team on medication or special compression stockings.
• Wait for two days before you shower, removing any dressings beforehand.

Most people make a good recovery and return to their usual activities within two weeks. Here are a few things you can do to make sure you recover well:

• Gradually increase how much you walk over the first few days.
• Regular exercise should help you return to normal activities.
• Do not do any strenuous exercise for three weeks.
• You do not need to avoid heavy lifting, but you may find it uncomfortable to do so in the first two to four weeks.
• Do not bathe or use pools or hot tubs for two weeks after surgery.

If you notice any of the following symptoms, contact your consultant or GP straightaway as it can be a sign you have a serious complication.

• Pain that gets worse over time or is severe when you move, breathe or cough.
• A high temperature.
• Dizziness, feeling faint or shortness of breath.
• Feeling sick or not having an appetite, which gets worse after the first one to two days.
• Not opening your bowels and not passing wind.
• Swelling in your abdomen.
• Difficulty passing urine.