Hernias

A hernia is a lump that sticks out through a weakness. This can happen anywhere in the body but the hernias I deal with are associated with the abdomen and groin.

What should you look out for if you have a hernia?

Case study: A Patient with an inguinal hernia

Case study: A patient with an abdominal wall hernia

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.

Hernia

In general if you have surgery – the advi​ce 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.

umbilical-hernia

​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

epig-hernia

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.

spig-hernia

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

Clinical-presentation-of-a-patient-with-a-large-incisional-hernia-Conventional-hernia

Groin hernias

Inguinal hernia

T​his 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

T​his 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

What is a hernia?

​What exactly is a hernia?

What happens during hernia surgery?

What happens during hernia surgery?

What does hernia repair involve?

What happens during hernia surgery?

After hernia surgery

What should and shouldn't I do following hernia surgery?

Time off work after hernia surgery

Will I need time off work after my hernia repair?

Driving after your hernia repair

When will I be able to drive after my hernia repair?

Patient Testimonials

“I was so pleased knowing I was in safe hands.”

Mr Peravali showed me great respect and impressed me right from my first appointment gaining my full trust. I was so pleased knowing I was in safe hands. His knowledge and reputation in what he does is superb. I very much appreciated Mr Peravali visiting me the very next morning after the operation to check and ensure everything was ok. The information he provided me about before, during and after the operation was great and very useful. I thank sincerely Mr Peravali for taking good care of me.

Mr Peravali was extremely professional whilst being approachable to ask any questions about the operation and recovery. His supporting team made me feel like I was in safe hands, again exchanges of conversations between us made me very relaxed.

“I cannot fault the care I received”

I would like to take this opportunity to thank you and your team for the care and kindness you showed me before during and after my prolapse operation. I cannot fault the care I received and I hope you carry on providing this high level of care to your patients.

Mrs. F.A

"I have no hesitation in recommending your skills to other people"

You carried out an operation for my abdominal hernias at Spire Little Aston Hospital.

I wish to express my thanks to you and your staff for the high standard of clinical and patient care I received. The pain and discomfort from the hernias have gone and I now feel so much better after the operation.

Thank you so much and I have no hesitation in recommending your skills to other people with similar problems.

Mr. B.B.

"The care I received was first class"

Just a short note to thank you and your team for the treatment and care you gave me during and after my cancer operation.

After first meeting you,  both my wife and myself had total confidence in you. What really impressed us was the aftercare you and your team provided.

The care I received was first class and I witnessed first-hand how dedicated you and your team are to your patients.

Mr. L.D. & Mrs. T.D.

"We really appreciated your honest and comforting approach"

I would like to say a big thank you to you for my mom’s treatment. We really appreciated your honest and comforting approach and support – sometimes with not good news but always with a smile, a plan and complete reassurance that in your hands my mom would be ok.

We particularly welcomed your well needed lightness and laughter.  On the day of the surgery you took time to talk to my mom as well as myself and my sister which really helped us all. My mom has made a fantastic recovery and is better than ever – thank you once again and we will be for ever indebted to you.

Mrs. M.K.

"Excellent outcome"

We are writing to say how pleased we are with Dr Rajeev Peravali who saved my mum’s life in March when she was admitted to Hospital with severe abdominal pain. She had an ileostomy at the time. He subsequently reversed her ileostomy and has had an excellent outcome once again thanks to Dr Peravali.

Mrs. A.S. & family

"Helped me a great deal"

I would like to take this opportunity to thank you and your team for the surgery you performed to remove a cancer from my colon.

I would also like to thank you for the time and information you gave me throughout and after the procedure, I found that helped me a great deal.

Mr. R.U.

"The work you do is outstanding"

I would like to say a huge thank you to you and your team for the specialist care you gave throughout my operation. The work you do is outstanding and I will be forever grateful for what you have done for me.

Mr. D.W.

"I will never be able to thank you enough"

I am writing to express my gratitude for the treatment I received at your hands. Everyone was so wonderful. The day I was admitted to hospital was one of the toughest times in my life. The personal attention and kindness shown by you, coupled by the caring attitude of the hospital staff helped me overcome my fears about surgery.

I want you to know that you are doing a wonderful job and I will never be able to thank you enough. The support and advice I received from you before undergoing the surgery was crucial in my speedy recovery. I will recommend you not just as a doctor but also as a great human being who is a good listener with lots of patience with a caring attitude.

Mr. I.W.

"Very very pleased thank you."

I felt very relaxed and confident with Mr Peravali’s explanation of the procedure to take place. After the procedure I am really pleased with the outcome .could not have been better no pain no inflammation. Very very pleased thank you.

 

 

"Was easy to speak to and be empathetic."

Mr Peravali was very approachable made me feel at ease, wanted to help with my pain and felt he meant it. Was easy to speak to and be empathetic. Had been putting off seeing anyone but if I had known what the consultant was like I would have gone sooner.

 

"Very efficient and gave me a lot of confidence about the operation"

Wearing hearing aids makes life a bit more complicated , Mr Peravali was very patient with me and made sure I understood everything . Very efficient and gave me a lot of confidence about the operation . Also found time to pass a few pleasant remarks .

My consultant shows that he's competent and is experienced in what he does. I think he was being thorough with the procedure to make sure I was in the clear. Thanks again to Mr Peravali

The consultant was very good. He came to talk me through the procedure before hand and asked if I had any questions. He also came after the procedure and told me how it went again asking if I had any questions. He also explained how my recovery should go. Thank you Mr Peravali

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