Definition of a Hernia: A hernia occurs when part of the intestine pushes through a weakness in the abdominal wall. This causes a visible bulge in the groin area, known as an inguinal hernia. Hernias are more common in males, and may be present at birth or develop later in life while straining, lifting, or coughing, or if obesity increases pressure in the abdomen.
This article on abdominal hernia repair surgery is written by Jackie Griffiths, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.
A hernia is not dangerous on its own, although there’s a risk it could become trapped (strangulated) which cuts off the blood supply to the affected area. This can cause life-threatening conditions such as gangrene and peritonitis. If left untreated, a hernia is likely to get larger and result in the bowel being obstructed.
In order to treat a hernia, a hernia repair operation is required to push the intestine back in place and strengthen the abdominal wall. It is a simple procedure that can be carried out under local or general anaesthetic, and you can usually return home the same day. If possible, a keyhole (laparoscopic) procedure will be performed which minimises the size of the incision and reduces the risk of complications. Otherwise, in the case of large hernias, open surgery is needed.
Before the operation
There are certain things you can do to reduce the risk of complications when undergoing a hernia repair operation. Quitting smoking and losing weight are two fundamental starting points. Get advice from your doctor if you have existing problems with your blood pressure, heart, or lungs, or if you take the contraceptive pill or are having hormone replacement therapy (HRT).
On the day of your hernia repair operation, take a bath or shower at home and remove all make-up, nail varnish, and jewellery. Take any medication with you to the hospital. Make sure you have a friend or relative available to get you to, and from, the hospital, and to look after you for the first week after surgery.
Do not eat or drink for six hours before undergoing general anaesthesia, as per your doctor’s instructions. However, occasional sips of water may be allowed for up to two hours beforehand.
Once the anaesthetic has taken effect, two or three small cuts about 1-2cm long will be made on your lower abdomen. A small tube-like telescopic camera is inserted to view the hernia on a video screen. Hernias are repaired using special surgical instruments designed to fit through the small incisions. A synthetic mesh may then be stitched over the weak spot in the abdomen for extra strength. Finally, the skin is closed with dissolvable stitches.
In a hernia repair operation by open surgery, a single cut about 5-10cm long will be made in your groin in order to push the hernia bulge back into place. As with keyhole surgery, a synthetic mesh may be applied over the abdomen and the skin closed with dissolvable stitches.
The hernia repair operation takes between 30 and 50 minutes depending on the technique used.
After the operation
If you had your hernia operation under a general anaesthetic, you will be taken from the operating theatre to a recovery room where you will regain consciousness under close supervision. You will then be taken back to your room to rest where the nurse will check the operation site, monitor your heart rate and blood pressure. Your groin is likely to feel sore, in which case the nurse will give you painkillers. You may drink and eat again when you’re ready.
After your hernia repair operation, you will be allowed to go home once you have made a full recovery from the anaesthesia. However, someone else must drive you home and stay with you for the first 24 hours.
Continue taking painkillers if needed. You may be prescribed antibiotics to ward off infection along with information on how to care for, and bathe, your wound. Note that general anaesthesia can temporarily impair your co-ordination and reasoning skills – so do not drink alcohol, operate machinery, or sign legal documents for 48 hours post-op.
Eat lots of fruit, vegetables, and high-fibre foods to avoid constipation as this can cause straining (and discomfort) at the site of the wound. Your dissolvable stitches will disappear on their own after 7-10 days.
Complications in treating hernias are rare and seldom serious. Bruising and swelling may be troublesome, particularly if the hernia was large, and may take 4-6 weeks to settle down. Infection occurs in 1-2% of cases and can be treated with antibiotics. Aches and twinges may be felt in the wound for up to six months. The chances of a hernia coming back after a hernia repair operation is less than 5%, and is more likely to occur in the elderly and infirm.