HERNIA SURGERY

Hernia surgery is indicated for 

• Hernia causing symptoms 

• Hernia that is increasing in size 

• Specific types of hernias at high risk of complications, such as femoral hernia and Spigelian hernia 

Hernia surgery can be performed through laparoscopic or open technique. It is usually performed under general anaesthesia, however, open surgery may be done under regional anaesthesia.

An incision is made at the site of the hernia. The protruding tissue and organs are pushed back into the abdominal cavity. There are various techniques for closing the defect. Small defects can be closed with sutures. Large defects are best dealt with by placing an artificial mesh over the defect, with the advantage that extra support is provided. The incision is closed with dissolvable sutures.

Laparoscopic (keyhole) surgery can be used to treat many types of hernias. Usually 3 small incisions are made in the abdomen. A laparoscope is inserted through one of the incisions. Carbon dioxide gas is blown into the abdominal cavity. Other surgical instruments are inserted. Tissue around the hernia is cleared away and the protruding tissue and organs are pulled back into the abdominal cavity. The defect is covered with an artificial mesh, which is anchored in place with sutures and dissolvable staples. All instruments are removed and the carbon dioxide is allowed to escape. The incisions are closed with dissolvable sutures.

Laparoscopic hernia surgery may not be suitable in some people due to

• Inability to have a general anaesthesia

• Scar tissue (adhesions) due to previous surgery

• Bleeding disorders 
  
  
• Pregnancy, especially during the final 3 months of pregnancy

All surgery has risks despite the highest standard of practice. The following possible complications are listed to inform not to alarm. There may other complications that are not listed. 

• Bleeding 
• Infection
• Injury to nearby structures, such as blood supply to the testicle in males with inguinal hernia 
• Chronic pain from involvement of nerve in repair 
• Hernia recurrence 

Hospital Stay. Most people go home on the day or morning after surgery. It is recommended that you be accompanied home by a carer who will stay with you (or very close by) for the first 24 to 48 hours. 

Wound Care. Your wounds are closed with dissolvable sutures and skin glue and covered with waterproof dressings. You can shower normally. You will be given instructions on when to remove your dressings. 

Driving. You should not drive for at least 24 hours after general anaesthesia. You can start driving as soon as you can safely control the vehicle, usually after 1 week. 

Physical Activity. You are encouraged to do as much walking as is comfortable. Limit your activities to light duties (no lifting over 5 kg) for at least 4 weeks, or until you are comfortable. The common sense rule is “If it hurts, don’t do it!”.

Each person’s recovery is different, and you will be given specific instructions.

Dr Mary Ling is highly experienced in both laparoscopic and open hernia surgery. She performs hernia surgery at Gosford Private Hospital and Brisbane Waters Private Hospital on the Central Coast. Dr Ling participates in the No Gap scheme if you have private insurance.