TREATMENTS

WHAT HAPPENS WHEN I COME TO THE HERNIA CLINIC?

You will be seen by a specialist consultant.

They will normally take a full history from you which will include items such as how long you have had the hernia. Is it getting bigger is it causing pain or interfering with your daily activities. Your consultant will also want to explore any potential causes of your hernia such as heavy lifting activities, straining or chronic cough.

We will also need to know about your past medical history including any previous operations anaesthetics or other serious illness. You should bring a full list of all your medications with you when you come to the appointment and report any known allergies.

The clinical examination includes a full examination of the abdomen. This will involve examination of the hernia itself. Groin hernias are often better assessed both in a lying position and a standing position. Your consultant may well get you to cough in order to better feel the hernia.

Some hernias are not easy to feel and a simple ultrasound scan may be needed to see them. For large abdominal wall hernias, a CT scan may be required.

Once the examination is complete your consultant will discuss the treatment options with you. This will include outcomes as well as any risks or complications for a procedure. The surgeon may complete a consent form with you in the clinic.

You will normally be able to arrange a date for surgery at the initial consultation if required. Alternatively, you may wish to book a date for surgery via our clinic secretary.

BEFORE ADMISSION TO THE HOSPITAL

All the details regarding the admission will be sent out by post to you by the hospital. This will tell you when and where to come. You will receive instructions about when to stop eating and drinking.

If you have any other medical conditions such as heart or lung disease or diabetes you may be asked to attend a pre-assessment clinic in the week before surgery. You may have blood tests taken and an ECG. You will also be given advice about any medications that you take. It is very important for us to know about any anticoagulant drugs, including aspirin, that you might be taking.

5 TERMS DOCTORS USE TO DESCRIBE HERNIAS

1. REDUCIBLE: This means that a hernia goes away when lying down or can be pushed back into the abdomen.

2. IRREDUCIBLE: This means that the hernia never goes away and cannot be pushed back into the abdomen.

3. INCARCERATED: This means the same as irreducible, the hernia never goes away and cannot be pushed back into the abdomen. It may be more often used if the hernia has been like that for some time.

4. OBSTRUCTED: This may happen to an incarcerated hernia. A part of the intestine which is in the hernia becomes blocked and nothing can pass through it.

5. STRANGULATED: This may happen to an incarcerated hernia. The blood supply to the contents of the hernia is cut off. This will lead to the death of tissues trapped if it is not relieved quickly.

COMING TO THE HOSPITAL

Remember you will be having an operation and a general anaesthetic. You will need someone to bring you up to the hospital as you will not be able to drive yourself home.

If you live alone, you can still go home on the same day as the operation but you should either arrange for someone to come and stay with you for 24hrs or go and stay with someone yourself.

Most hernia repairs are performed as a day case so you wont need to bring things for an overnight stay. A dressing gown and slippers are useful as we often walk patients to the theatre.

Remember to bring clothes that are easy to get on and off. They shouldn' be too tight as this may be uncomfortable after an operation. Clothing with an elasticated waist band is ideal if you have it.

For men with groin hernias brief type underpants are better than boxer shorts as they will give some additional support.

You don't need to shave the area of the hernia before you come into hospital. We will do this ourselves just before the operation.

Once you arrive at the hospital the reception staff will confirm all your details. You will be shown to the ward by our porters.

On the ward you will be seen by a nurse who will complete the admission process and you will also be seen by your surgeon and anaesthetist. If you haven’t already completed a consent form this will be done before you leave the ward. Your surgeon may need to draw an arrow on your skin to indicate the site and side of the hernia.

IN HOSPITAL AFTER THE OPERATION

After the surgery The nursing staff on the ward will try to get you up and moving around as quickly as possible.

We want to make sure that you have had something to eat and drink before you go home. We also like to make sure that you have passed urine before leaving.

Your wound will be checked before you go to make sure there isn’t any excessive blood on the dressing or undue swelling.

AFTER YOU HAVE GONE HOME

Once you are at home it is important to stay active with short regular walks building up the time and distance each day.

After the operation we recommend showering rather than bathing as patients will be uncomfortable and it could be quite difficult getting into and out of a bath.

You can normally take a shower after 24hrs. Don’t worry about getting the dressing or the wound wet simply remove the wet dressing. Dab the area dry with a towel and put a clean dry dressing on.

The main reason for using a dressing is to stop your clothes from rubbing the scar directly. If there is any discharge a dressing will also protect your clothes.

If you have skin stitches we would normally arrange for these to be removed between 10 and 14 days after surgery.

There are no hard and fast rules about dressings. Most people will be able to stop using a dressing within 2 weeks of the operation.

As already mentioned we encourage all patients to stay active following surgery. Walking regularly is the most useful exercise after the operation. You should avoid heavy lifting for 4-6 weeks after the operation. After about 4 weeks you should be able to increase your exercise activities. Starting with gentle rhythmic exercises such as cycling or cross-training and gradually building up to your normal exercise regimen. Provided there are no wound problems swimming can also be good at this stage.

You should be able to return to work within one or two weeks but if your job involves any strenuous activities you may need to be off work for longer or carry out only light duties.

Patients can usually drive again after one to two weeks but your surgeon will give you specific instructions regarding this.

We aim to see patients back in clinic after about 6 weeks but we can always see patients sooner if there is a problem.