Overview
It is important to get hernias assessed as they can get strangulated or obstructed. This is when the contents of the hernia become really hard and painful because the blood supply to the contents is compromised. If you have a strangulated or obstructed hernia you will need to attend the hospital as an emergency and will likely that you will need emergency surgery. The risks of emergency surgery are far greater and you may end up with part of your bowel being resected.
In general if you have surgery – the advice for all these types of surgery is the same:
- You are allowed to walk and do gentle activity for the day of the operation.
- Generally speaking, you will need at least 2 weeks off work – more if you have on going pain or if you do a particularly active or physically demanding job.
- Avoid heavy lifting and contact sports for at least 6 weeks.
- Driving is not advised for 2 weeks. You will need to get in to the car and practice doing an emergency stop. If you can do it with out feeling any pain –you are probably ready to start driving. You will need to let your insurance company know and they will need to be happy for you to drive. Rules do vary between insurance companies and it is important to check with your particular insurance company.
Umbilical/paraumbilical hernias
The most common hernia on the abdominal wall is one through a weakness through or near the belly button or umbilicus. These are relatively simple to fix with an operation. You will need a general anaesthetic. Usually a small cut or incision is made over the hernia. The hernia is pushed back and the weakness is sewn up. The weakness may be reinforced with some netting known as a mesh.
The procedure is usually done as a daycase and you are home the same day.
Epigastric hernia
These hernias are very similar to umbilical hernias and are treated in the same way. They tend to be located above and some distance from the belly button and below your breast bone.
These are relatively simple to fix with an operation. You will need a general anaesthetic. Usually a small cut or incision is made over the hernia. The hernia is pushed back and the weakness is sewn up. The weakness may be reinforced with some netting known as a mesh.
The procedure is usually done as a day case and you are home the same day.
Read more about Epigastric Hernia treatment
Spigellian hernia
This is another kind of abdominal hernia which is actually quite uncommon.
The weakness is usually on the side of your abdomen.
This type of hernia can be treated by key hole or open surgery.
I will discuss the best treatment for you in clinic.
Incisional hernia
This is where there is a weakness in your abdominal wall from previous surgery. These can sometimes be very large and do vary considerably in how severe they are.
Again key hole or open surgery may be appropriate dependant upon your particular situation.
With these complex hernias additional information may be needed before surgery and we may need to do a CT scan. Read more about Incisional Hernia treatment
Groin hernias
Inguinal hernia
This is a hernia through a weakness in the groin. It can happen in either groin and it is reasonably common to have hernias in both groins.
This type of hernia can be operated by key hole means and also by traditional “open” surgery. I offer both and whilst I tend to operate mostly by key hole means we will discuss the best option for you.
Repair involves pushing the hernia back and re-enforcing the area with netting or a mesh.
The advantage of key hole surgery is that you will often have less pain and will usually be able to return to normal activities of daily living quicker.
I will discuss the details of the operation and which is best for you in clinic.
Femoral hernia
This is a hernia through a weakness in the groin. It can happen in either groin and it is reasonably common to have hernias in both groins.
Femoral hernias can be operated by key hole means and also by traditional “open” surgery. I offer both and whilst I tend to operate mostly by key hole means we will discuss the best option for you.
Repair involves pushing the hernia back and re-enforcing the area with netting or a mesh.
The advantage of key hole surgery is that you will often have less pain and will usually be able to return to normal activities of daily living quicker.
We will discuss the details of the operation and which is best for you in clinic. Read more about fermoral hernias
What should you look out for if you have a hernia?
Hernias are common and unless they are causing pain many NHS Trusts do not fund surgery.
Important things to look out for:
- Is it getting bigger – the bigger the hernia the more difficult it is to operate. If the hernia is visibly getting bigger it is wise not to delay surgery.
- Is it painful?
- Has it stopped going back inside? This is a sign that it may be at risk of obstruction or strangulation and it would be wise not to delay surgery.
- Is it stopping you doing things? Several of my patients (keen sportsman, dancers, walkers and gardeners) with hernias were restricting their activities because of their hernia. Many were back to normal activities only a few weeks after surgery – particularly if they had keyhole surgery.
Case study: A patient with an inguinal hernia
Mr H is a keen gardener and dancer. He has been dancing for 75 years since he was 12! He had noticed a lump in his groin for several months and ignored it. He decided to see Mr Peravali as it started to become more painful particularly after dancing. Mr Peravali diagnosed an inguinal hernia and recommended a key hole repair so Mr H could get back to dancing as soon as possible.
Mr H had an uneventful operation and was discharged home the same day. He was dancing again within a few weeks.
Case study: A patient with an abdominal wall hernia
Mrs EF had been seen in her local NHS hospital with a large hernia in her abdominal wall. She had been told that she needed an operation and would be put on the waiting list. She was told the waiting time may be as long as 10 months as she was not a “priority”. She was understandably upset by this and made an appointment to see Mr Peravali. Mr Peravali saw her in clinic within 48 hours and operated 10 days later. She made an excellent recovery and is very happy with the result.
Videos about hernia surgery
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