Inguinal Hernia Repair

info sheet

The information here is a guide and reflects only the views of Prof. Fawcett and Dr Slater

WHAT IS AN INGUINAL HERNIA?

An inguinal hernia is due to a protrusion of bowel or other abdominal contents through a weakening in the groin. Hernia may occur on either side or on both sides.
They occur more commonly in men but women are also affected. In men, the descent of the testicles through the groin leaves the area weak.
Hernias occur at any age from newborns to the very elderly.

WHAT ARE THE SYMPTOMS OF AN INGUINAL HERNIA?

Most patient’s present with a lump in the groin. It is usually something that develops slowly, but some people describe a lump suddenly appearing after heavy lifting.
The lump gets bigger after a day of standing up and usually goes away when the patient lies down.
If the lump becomes suddenly painful, then it is possible that the hernia has become trapped. If this occurs, you should lie down immediately, try to relax and gently press over the lump to make it go back in. If the lump goes back in, you should contact your surgeon and let them know what has happened. If it does not go back in, or remains painful in any way, you should urgently attend the emergency department.

WHY SHOULD A HERNIA BE REPAIRED?

Once you have a hernia, there is nothing you can do to make it go away. As time goes on, they become progressively larger and more uncomfortable.
Groin support garments or trusses do not work and can make the hernia worse.
The most serious complication of not repairing a hernia is strangulation of a piece of bowel contained in the hernia. This may require a big operation to remove a piece of bowel.

WHO IS MOST AT RISK TO GET AN INGUINAL HERNIA?

HOW IS AN INGUINAL HERNIA REPAIRED?

There are two ways to fix an inguinal hernia

In my experience and in the literature, there is very little difference in recovery between the two techniques. Both methods are currently very acceptable.
In open inguinal hernia repair, a small cut is made over the lump. Then the contents of the hernia lump are reduced and placed back in the abdomen. A “tension free” repair is then performed to cover the hole that the hernia has come through. This is done by inserting a soft nylon “mesh”. This mesh acts like a frame, for your body to grow strong fibrous tissue into and repair the defect. The mesh used partially absorbs over time and you will not feel it.

WHAT TYPE OF ANAESTHETIC WILL I HAVE?

Hernias may be repaired under general anaesthesia (completely asleep), regional anaesthesia (needle in the back to numb the legs but you are awake) or local anaesthesia (injections into the groin to numb the area, you are awake). Your anaesthatist will discuss this with you.

WHAT ARE THE COMPLICATIONS OF INGUINAL HERNIA SURGERY?

Specific Risks:

It is also quite common for there to be some bruising around the wound. With time, this bruise may travel down and cause bruising on the penis and scrotum. This will get better.

General Risks:

WHAT TO EXPECT IMMEDIATELY AFTER SURGERY

Pain Relief

Every effort will be made to minimize the discomfort. Your surgeon and nurses will be monitoring your level of pain control frequently.
Local anaesthetic will be used in the wound and lasts for about 12 hours.

There are two major types of pain relievers after hernia surgery.

Eating

It is usual to return to a normal diet within a day of hernia surgery. There are no restrictions.
It is very common to feel slightly nauseated for 12 hours following surgery.

Urinating/Bowel Movements

After any surgery a patient may have trouble passing urine. This is uncommon and usually temporary. Occasionally a catheter needs to be inserted to help you pass urine.  (see above)
There may be some disturbance to your bowels in the week after surgery. Discuss this with your local doctor if this occurs.

Activity

It is usual to be discharged one – two days after routine hernia surgery. It is very important to begin light activity shortly after surgery. This is to prevent pneumonia, clots in the legs and loss of general condition. You must not lift heavy weights or play strenuous sport until six weeks after your surgery. After this time, the wound will not get any stronger.

AFTER DISCHARGE

Your Incision

You can expect to have a waterproof dressing over your incision. You may remove this after five days or earlier if it is dirty. You will be able to shower with this dressing. It is quite common to have a small amount of leakage from the wound or a bubble of fluid under the dressing. 
You can peel the dressing off 5 days after the surgery. The wounds should be healed by this time. It is common for the wounds to be bruised.
You may get the wounds wet after 5 days. Gently wash dried material around your incision and let water run over it. Pat it dry with a towel. Do not rub soap or moisturizer into your incision for at least 4 weeks or until it is fully healed. After this you may rub vitamin E cream along the wound.
Most commonly you will not have stitches to remove; they will be of the dissolving type.
Your incision may be slightly red along the cut. This is normal.
It is normal to have a hard ridge of tissue under the wound. All patients get this and it disappears after about three months. It is normal to feel a ridge along the incision. This will go away. It is normal to have a patch of numbness under the wound.
Over the next few months your incision will fade and become less prominent.

Activity

How you may feel

It is quite common to feel quite tired for a few weeks after surgery.

Costs to be incurred from this surgery

There will not be any out of pocket expenses for your surgery. Your health fund will be billed directly. Outpatient consultations are not covered by the health funds and there will be a small out of pocket fee. An account will be sent to your home address. You will get some of the money for outpatient consultations back from Medicare.

Your anaesthetist may also charge an out of pocket fee. You should ask them ahead of time about this cost. Ask who will be performing your anaesthetic and you can make enquiries with them as to any out of pocket expenses.
You will also have to pay any hospital excesses that your policy dictates.