Hernia repair surgery Pokanga whakatika whaturama
An abdominal hernia is a lump that happens when an organ or tissue pushes through a weak spot in the wall of your tummy (abdomen). Some hernias may need hernia repair surgery to fix them.
What hernia repair surgery is
Hernia repair surgery can be done in 2 ways:
- keyhole surgery (also called laparoscopic surgery)
- open surgery, which uses a larger cut.
With keyhole surgery, the surgeon makes several small cuts in your tummy. They insert surgical instruments, including a telescope with a light, into your body through these small cuts to find and repair the hernia.
The hernia is repaired by pulling together muscles and ligaments to close the opening or by using surgical mesh. Mesh is a loosely woven sheet, typically made of a sterile, woven plastic-like material such as polypropylene.
Studies of hernia repairs show that using a mesh is the best way to repair hernias. Without using a mesh, it is difficult or impossible to repair some hernias.
The use of mesh is considered safe for repairing abdominal hernias.
The day of your hernia repair
You will usually have a general anaesthetic (where you are put to sleep) for your hernia repair surgery. Some people have a local or regional anaesthetic instead. You may go home the same day without staying overnight. But if you have a larger hernia, you may need a few days in hospital to recover from the surgery.
You may be able to get your hernia repair through the public health system. ACC may fund your surgery if your hernia was caused by an accident or has developed around the scar from a previous surgery (called an incisional hernia).
Talk to your healthcare provider about what options you have. You may choose to pay for a private general surgeon to perform your hernia repair.
The Accident Compensation Corporation (ACC) is a government agency that helps pay for treatment if you are injured in an accident.
The ACC provides comprehensive, no-fault personal injury cover for all residents and visitors to Aotearoa New Zealand. This means if you are hurt in an accident, ACC can help no matter who caused the accident.
If you have an accident and need emergency care in a hospital, it will be covered by ACC.
ACC usually pays some of the other medical costs if you have an accident, like surgery, physiotherapy and medicines. ACC may also be able to cover some loss of earnings resulting from an accident.
I'm injured — The Accident Compensation Corporation
Risks and complications of hernia repair surgery
Most hernia repairs are low risk, but all operations carry some risk and it is important to discuss this with your surgeon before you decide to have surgery.
Tell them about any problems you have had with operations or healing, including reactions to medicines. The risks below are not the only risks but are the most common ones or the most serious.
Specific risks of hernia repair surgery
After surgery, some people get a fluid-filled area called a seroma. This may need draining. Seromas are common after larger hernia repairs.
A few people (less than 1 in 10) get chronic (persistent) pain after open surgery for an inguinal hernia repair. This is less of a risk after repair by keyhole surgery. People who have mesh hernia repairs are less likely to have chronic pain than people who have repairs without mesh.
Infection in the mesh after hernia surgery is rare. It happens in less than 1% of surgeries. This risk is even lower after keyhole surgery.
Very rarely, there is injury from surgery that affects the bladder or bowel.
Your hernia may also come back after being repaired. This happens in around:
- 1% of open inguinal hernia repairs
- 0.2% of laparoscopic inguinal hernia repairs
- 10% of incisional hernia repairs.
Informed consent
Healthcare services may be provided to you only if you make an informed choice and give informed consent to it. This forms part of your rights (Rights 5, 6 and 7) under the Code of Health and Disability Services Consumer Rights (the Code).
The Code and Your Rights/Ōu Mōtika — Health & Disability Commissioner
The 3 rights that together allow for informed consent are:
- Right 5 — the right to effective communication
- Right 6 — the right to be informed
- Right 7 — the right to choice and consent.
This means you must be told about the service being suggested, including any risks or possible complications. You must have the chance to ask as many questions as you need to understand the information you are given.
You also have the right to have someone with you to help you. But the decision to say 'yes' or 'no' must be yours (unless you are unable to make that decision due to illness or other impairment, or sometimes in an emergency).
You also have the right to be given the information in a language you fully understand. You can ask for an interpreter if you need one.
After hernia repair surgery
After your operation, you may notice your tummy sticks out more than usual, making it difficult to do up things like trousers and belts.
Your abdominal muscles will partly stop working, making it difficult to sit up, especially on the day of surgery. But they are likely to recover quickly.
If you had keyhole surgery for an inguinal hernia, there is nothing specific you should avoid doing once you go home. You can drive once you feel you can safely press the brake pedal in an emergency.
With a larger hernia repair, do not drive or do any heavy work until your surgeon has said it is okay to do so.
There are some things you should expect or might look out for as you recover from your hernia repair surgery — and some important self care to help you recover.
For keyhole inguinal hernia repair, if you have a desk job, you may need about a week off work. If you do physical work, you will need around 2 weeks. If your job involves heavy lifting, it is best that you avoid this until your wound has healed enough (around 4 weeks). Avoid anything that causes strain or pain around the site of your repair.
For open surgery or larger repairs, you will need around 4 weeks off work and should have a check up with your surgeon before you return to work.
It is common to have some pain in your groin or wounds for around a week after the operation. It is not usually severe. Men sometimes get pain in their testicle on the side of the repair, starting a few days after the operation and usually going away within 48 hours.
Usually, it is enough to take oral pain relief medicines. If you cannot take anti-inflammatory medicines, check with your healthcare provider or pharmacist what the best alternative is.
Pain relief medicines for adults
You can expect bruising, and your surgical wound is likely to feel firm for 6 to 8 weeks.
Bruising tends to spread downwards from your wound — for men this can be into the testicles and penis. This often looks worse than it feels. Do not be alarmed — it will fade within a week or 2 weeks.
You may also get some swelling, but this does not mean the hernia is still there. Your body will slowly absorb this fluid.
See your healthcare provider if you have a fluid-filled lump (called a seroma) that is bigger than a walnut. Sometimes these heal more quickly if your healthcare provider removes the fluid (called aspirating). Sometimes this can risk causing infection.
After the operation there will be thin tape covering your wounds. After a shower, pat the dressings dry with a towel. You can take the tape off 7 days after your operation.
It is rare for these wounds to get infected but see your healthcare provider as soon as possible if:
- your wound is weeping
- your wound is getting more sore or red
- you are feeling unwell, for example you have a fever or feel sick (nausea).
You probably will not have any visible stitches but if you do your surgeon or nurse will let you know about when and how they will be removed.
For an inguinal hernia repair, you may not have a follow-up appointment with a surgeon, but you can see your healthcare provider if you have any problems after your surgery. They can refer you back to the surgeon if necessary.
For larger hernia repairs, you will need a check up with your surgeon before you go back to work, drive or do any heavy lifting.