HERNIA REPAIR SURGERY
At a glance
Hernia repair surgery is done to treat an inguinal, femoral or umbilical hernia. A hernia is a bulge or protrusion of fatty tissue or bowel through a weakness in the structures or muscle wall that contains it. Hernias are commonly caused by pressure onto a weak spot in the muscle or postoperatively over an incision site. Surgery is thus advised to push the bulge back inside the body and close the anatomical defect.
If surgery is not performed, tissue or bowel may become trapped, causing pain and discomfort. If bowel becomes strangulated, this is dangerous as the blood supply to the bowel will be cut off, resulting in the tissues dying and leading to perforation of the bowel and leakage of bowel contents into the abdomen. This situation is associated with high morbidity and can be fatal; emergency surgery is required.
The different types include:
- Inguinal hernia - this type occurs when a segment of the intestine pushes through the abdominal wall into the inguinal canal.
- Femoral hernia - when the intestine protrudes into the canal carrying the femoral artery into the upper thigh, a hernia may develop.
- Umbilical hernia - this type occurs due to a protrusion of the small intestine through the abdominal wall, around the belly button.
How to prepare for the procedure
A hernia repair surgery may be done through open or laparoscopic surgery. Which of the two methods used will depend on the size, type, and location of your hernia. Before hernia repair surgery, Dr Maraj will advise you on how to prepare for the procedure. You will need to restrict your eating and drinking 6 hours before the procedure and the surgery is done in the theatre, under general anaesthesia or regional spinal block. You may need to stay in hospital overnight for observation.
What hernia repair surgery involves
Once a general anaesthetic or after a regional spinal block has been performed, your hair will be clipped, and a urine catheter will be inserted. Dr Maraj will make an incision. Your surgeon will then perform a herniorrhaphy (tissue repair) or hernioplasty (mesh repair). From there your surgeon will gently push the tissue or organ back into the cavity, and close the weakened area of the muscle with stitches and cover the weakened area with a type of mesh, strengthening the weak spot. Which of the two approaches will depend on the type of hernia and patient factors.
If Dr Maraj deems suitable, your hernia repair may be done using minimally invasive laparoscopic techniques. During laparoscopic surgery, instead of larger incisions, your surgeon may make small puncture-like incisions instead. She will then insert a thin tube-like instrument, fitted with a camera at the end. This camera will provide your surgeon with a visualisation of the internal structures, and guide surgery. Using tiny surgical tools, the hernia can be pushed back into place, and the weakened area of the muscle wall can be repaired. This technique is also known as keyhole surgery.
What to expect post-procedure
Afterwards, you can expect some bloating, gas and cramping, as well as some slight pain near the incision site. Other complications include urinary retention, bleeding and infection; these are rare but may occur in the postoperatively period. You will need to stay in hospital overnight for observation after the surgery. If laparoscopic surgery was done, you can expect less pain and faster recovery time. For recovery, after open surgery, you can expect to be back to normal activities within a week or two, with recovery in 6 weeks.
As this is merely a basic explanation of the procedure, Dr Maraj will be able to provide you with any further information.
Risks & complications
Guidelines and protocols are followed to prevent complications. Complications are rare but not remote, and hernia surgery includes the following complications: Infection, recurrence of the hernia; damage to surrounding tissues, vessels or nerves and chronic pain, bleeding, urinary retention, infertility. You will be monitored closely by Dr Maraj after surgery for complications and if they occur, they will be treated appropriately. Management of these issues may require further hospitalisation.
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