| Part one covers the description of what a hernia is | | | | Pain is usually worst getting up from sitting or lying and |
| and its surgical and non-surgical treatment, moving on | | | | when getting back into bed or a chair, due to the |
| now to laparoscopy and post op management. A | | | | stitches in the repaired muscles pulling on these |
| double hernia where both sides of the groin are | | | | movements. Analgesics are prescribed to maintain |
| affected is best repaired using a laparoscopic | | | | activity and allow comfortable sleep. |
| technique which is also best for recurring hernias as | | | | Pulling and aching as the tissues stretch and become |
| the surgeon can avoid going in through previously | | | | more mobile is common in the first four weeks as the |
| scarred areas. Five year results of these operations | | | | amount of activity increases and the plastic mesh |
| show that laparoscopic results are as good as open | | | | settles in. Careful washing of the wound with water |
| results but over longer times than this any differences | | | | and soap in a shower or a bath is allowable after |
| have not been shown. Laparoscopic surgery has the | | | | about a couple of days once the dressing has been |
| advantage of the patient being able to get back to | | | | taken off. Talc should be avoided for about seven |
| activity quicker but the ability to use a local anaesthetic | | | | days. A transparent dressing can be used which is left |
| means that open repair is better for a first repair. | | | | in place for several days and allows both bathing and |
| Hernias can be repaired under general and local | | | | washing. The wound should be dry and well healed by |
| anaesthetic, the general injected into the hand and the | | | | about ten days after the event, making swimming |
| local anaesthetic is injected into the area of the | | | | unwise until this point. |
| operation. During repair under local anaesthetic the | | | | Patients can start to walk about as much as they |
| patient is aware that something is happening in the | | | | want although they will be quite stiff at first and |
| area of the operation but this should not be painful. The | | | | probably not feel like walking long distances during the |
| operation usually takes 30 to 60 minutes and even | | | | first week after the operation. Patients can start to |
| under general anaesthetic the surgeon will inject some | | | | drive the car when they feel confident to control it in |
| long acting local anaesthetic to make the patient more | | | | an emergency which is often about ten days after the |
| comfortable after they wake up. A long acting painkiller | | | | operation. Patients can return to work as soon as they |
| in the form of a suppository may also be used. | | | | feel comfortable enough to manage their job. People |
| For six hours before the operation patients should not | | | | who work from home or who can go back part time |
| eat any solid food and they should not drink for the | | | | often do so very soon after operation. |
| two hours leading up to the time. Patients may mobilise | | | | It is usual to feel stiffness in the abdomen whilst |
| whenever they feel well enough to get up and about, | | | | walking about although walking can be started |
| usually with someone helping them initially. If the | | | | whenever the patient feels like it. Longer distances are |
| surgeon uses wholly subcuticular stitches they do not | | | | unlikely to be achieved until the first week has elapsed. |
| need to be removed, but if skin clips or stitches are | | | | Patients can go back to car driving when they feel |
| used they should be taken out at one week. | | | | sure they can perform emergency control activities |
| The time a patient is discharged depends on how | | | | and this is unlikely to occur before ten days. Work |
| much pain they have, whether there is someone at | | | | return can be attempted whenever the patient is |
| home with them and how fit they are. The levels of | | | | comfy enough to get on with normal activities, although |
| pain felt after operation vary greatly between | | | | if they can work part time or from home they can |
| individuals, with some having very little pain but some | | | | re-start soon after operation. |
| levels of pain are to be expected in the first few days. | | | | |