Why would a hernia repair be needed?
A hernia is when part of an organ protrudes through the wall of the abdominal cavity. The most common hernia is an inguinal hernia which occurs in the groin region when a part of the intestine pushes thru a weak place in the abdominal muscles. A ventral hernia develops in the midline and is commonly a congenital defect where the abdominal cavity failed to fuse during embryological development. An incisional hernia occurs at the site where surgery was performed. Failure of the muscle layer to heal completely allows a part of the bowel to push through the abdominal muscles.
Hernias are divided into uncomplicated and complicated hernias. Uncomplicated hernias are easily reducible and does not cause severe pain. Complicated hernias are painful and may be associated with decreased blood flow to the content of the hernia, which might be a piece of bowel. A warm red skin in the area of the hernia, associated with nausea and vomiting is an ominous sign and emergency surgery may be needed.
How is a hernia repair done?
A hernia is repaired surgically to remove the protruding tissue and place it back in its original position to reduce discomfort and relieve pain. This surgery can be done using minimally invasive laparoscopic techniques; however, in emergency cases, open surgery may be better suited to restore the blood flow to the protruding organ.
Surgery may be done in the following way:
Laparoscopic hernia repair
Under general anaesthesia, Dr Aikman will make a small puncture-like incision into the middle of the abdomen. Through this small hole, a laparoscope, which is a narrow tube with a camera, will be inserted giving him full view of the internal organs while he performs surgery. Other thin tools are then inserted into the abdomen to reduce the content back into place and repair the weak area of the abdomen cavity with a synthetic mesh to prevent the hernia from re-occurring.
Open hernia repair
For open surgery, under general anaesthesia, Dr Aikman will make a larger incision over the hernia site. The contents of the hernia will be evaluated to ensure it is still viable. In severe cases a piece of bowel might need to be resected. The hernia itself will then be repaired and mesh will be used to strengthen the repair and minimize the chance of recurrence. If any tissue necrosis is present, the use of prosthetic mesh to strengthen the repair is not advised. This can be placed at a later stage.
What will recovery entail?
How long your recovery will be after surgery will depend on whether the hernia repair was done laparoscopically or through open surgery. If done laparoscopically, the incisions should be much smaller and thus the pain and recovery time is much less. The following symptoms are common after a hernia repair and should not be concerning:
- Pain responsive to analgesia.
- Pain when coughing, sneezing or laughing.
- Red skin around your incisions.
An unusually high fever, chills, vomiting, swelling and bleeding around the incisions, cramping of the stomach and excessive pain; however, should be reasons for concern and may require emergency care.
While you should be able to return to your normal lifestyle in a few days, you should be careful when doing physical activities. You will need to avoid heavy lifting or vigorous physical activity for at least 3 months after surgery. This is the time it takes for the prosthetic material to become incorporated into your tissue. After 2 weeks, your general surgeon will check your incisions and give you instructions for care in the following few weeks.