Hernia surgery

The abdominal cavity contains intestines and other structures. These are protected by the abdominal wall which is made up of four layers. The inner layer is membrane. The second layer is a wall made of muscle. A layer of fat separates the muscle from the outer layer of skin.

Weak spots can develop in the layer of muscle resulting in the contents of the abdomen, along with the inner layer, pushing through the abdominal wall. This produces a lump which is called a hernia.

Femoral hernia

A femoral hernia causes a lump down low in the groin. It happens at the hole in the wall of the abdomen where the femoral artery and vein pass from the abdomen into the leg.

Femoral hernias are operated on through a cut in the groin either directly over the lump or a little higher up. The operation takes 45-60 minutes and can be done under local or general anaesthetic.

Your surgeon will remove the hernial sac through the cut in your groin and will then narrow the hole (femoral canal) through which the contents of the abdomen passed using stitches or a synthetic mesh. Your skin will be closed with stitches.

Incisional hernia

An incisional hernia is a weakness in the abdominal wall which happens at the site of an incision made during a previous operation. The contents of the abdomen, along with the inner layer, can push through the weak healed site in the abdominal wall. This produces a lump which is called a hernia.

Incisional hernias can be repaired using the laparoscopic (keyhole) technique or by an open cut at the site of your hernia.

If your surgeon has recommended an open procedure then the operation takes about 90 minutes and is usually done under general anaesthetic.

Your surgeon will make a cut through your old scar to find out the extent of the weakness. They will then repair the weak tissue either with stitches or using a synthetic mesh under the skin. The surgeon may occasionally insert a tube to drain any blood. This will be removed after a day or two.

Inguinal hernia

An inguinal hernia is one of the most common types of hernia, causing a lump and sometimes pain in the groin. It occurs in the inguinal canal which is a narrow passage that blood vessels pass through in the abdominal wall.

Inguinal hernias can be repaired using the laparoscopic (keyhole) technique or by an open cut in the groin.

If your surgeon has recommended a laparoscopic procedure then the operation takes about half an hour and is usually done under general anaesthetic.

Your surgeon will make a small cut near your umbilicus so an instrument can be inserted that inflates your abdominal cavity with carbon dioxide gas. Two small cuts will be made or your abdomen to insert a small telescope and specialist instruments.

If your surgeon has recommended an open procedure then the operation takes about three-quarters of an hour and can be done under local or general anaesthetic.

Your surgeon will repair the hernia and insert a synthetic mesh to cover the weak spot. The cuts will then be closed with stitches or glue.

Paraumbilical and umbilical hernias

Paraumbilical and umbilical hernias are quite common as there is a natural weakness in the wall of the abdomen at the umbilicus. This is caused by the way babies develop in the womb. The hernia causes a bulge around the umbilicus and can cause pain.

Paraumbilical and umbilical hernia operations take around 30 minutes and can be done under local or general anaesthetic.

Your surgeon will make a cut around your umbilicus. They will free up the hernial sac, place the contents back in the abdomen and then remove the sac. Your surgeon will close the weak spot with strong stitches or a synthetic mesh. Your skin will be closed with stitches.

For all of the types of hernia, you should be able to go home the same day. Most patients will have pain for about a week and you may need painkillers to help you. You will be encouraged to increase your activity for the first few days after the operation.

You should be able to return to work after two to four weeks depending upon the extent of your surgery and your type of work

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