• Reference Number: HEY-780/2019
  • Departments: Upper GI

Introduction

This leaflet has been produced to give y'all general information about your process.  Nearly of your questions should be answered by this leaflet.  It is not intended to replace the word betwixt you and the healthcare team, but may deed equally a starting point for discussion.  If afterwards reading information technology you lot accept whatsoever concerns or require further caption, delight discuss this with a fellow member of the healthcare team.

Why do I need a hernia repair?

A hernia is a protrusion of abdominal contents through a weakness in the lining or muscle of the abdomen or groin area. This causes a bulge that may or may not be painful. Initially hernias contain internal fat but as the "gap" increases in size, occasionally the bowel can push button through, which can cause ache or pains.

In that location are diverse sites where a hernia may occur and the name of the hernia indicates the site. The inguinal hernia is the well-nigh mutual and occurs in the groin. Other sites include umbilical (effectually the navel) and femoral (at the pinnacle of the leg). An incisional hernia may too occur following previous surgery at a weak point in the scar.

If left alone, the burl (contents) might increase in size only the opening/ weakness can remain the same size. Sometimes fat or bowel tin can get stuck in the narrow "neck" of this weak bespeak. If non treated, hernias tin result in complications of blockage of the bowel (obstruction) or strangulation (loss of the blood supply). Your surgeon will discuss the balance of risks of "non-operation" (wait and see approach) against a planned operation. However, a await and see approach may allow the hernia to get larger or risk complications. If complications occur emergency surgery may be required, which may be more than invasive, such as bowel may need to be removed and risks are greater.

A truss for groin hernias does not usually hold the hernia back in identify and may cause complications if incorrectly fitted. Abdominal support "corsets" can be useful if repair of intestinal wall hernias is to be avoided and can back up repairs after an operation.

What is a hernia repair?

Most hernias are repaired under full general anaesthetic (while you are asleep) and occasionally some are carried out under local anaesthetic where the expanse is made numb and you lot remain awake.

To repair a hernia, the intestines or other protruding tissues are returned to their normal position and the weakness in the abdominal wall is repaired. Sometimes it is necessary to support the repair with a mesh patch stitched or stapled to the musculus inside the operation site. A canvass of mesh is normally used in groin hernia repair and larger hernias, as stitches alone may not be strong enough.

Open surgery involves making an incision in the skin and muscle layers large enough to find and repair the weakness. The size of the incision varies depending on the blazon of hernia existence repaired.

If "Laparoscopic" (keyhole) surgery is used, this will involve several pocket-sized cuts (approximately 1cm or less) which are made in the intestinal wall to place hollow tube "ports" into the cavity of the abdomen through which long thin instruments and a photographic camera are passed to allow the surgeon access to your organs.

The abdomen is temporarily inflated with a gas (carbon dioxide) to create the space in which the surgeon works. Information technology is necessary for you to take a general anaesthetic (be asleep) whilst your abdomen is distended by this gas. At the end of the operation the gas is released, the wounds are sutured and you are woken upwardly.

Tin can at that place be whatever complications or risks?

Possible complications of your item type of hernia repair volition be discussed with you by your surgeon and may include:

  • Conversion to a conventional open operation (uncommon)
  • Haemorrhage
  • Wound haematoma (old blood collecting under the closed wound)
  • Wound or mesh infection
  • Recurrence of the hernia
  • Scarring
  • Seroma (a drove of fluid between the pare and the muscle/mesh)
  • Deep vein thrombosis and pulmonary embolism (uncommon)
  • Bowel injury or peritonitis (very uncommon)
  • Need to render to theatre for further surgery (very uncommon)
  • Death (very uncommon)

In groin hernia repair may also upshot in the following complications:

  • Damage to testicular blood vessels or testicular damage
  • Urinary retentiveness
  • Chronic pain

Delight contact your doctor if you develop any of the following:

  • Abdominal swelling or worsening pain
  • A fever or shivering
  • Redness, swelling or pus drainage from the operation wound

How do I prepare for the hernia repair?

Please read the information leaflet. Share the data it contains with your partner and family (if you wish) so that they can be of help and support. There may exist information they need to know, especially if they are taking care of yous following this examination.

Earlier your operation

You volition be having a full general anaesthetic and will have a pre-operative screening engagement to assess your suitability for surgery, before yous are given a appointment for your operation. At this appointment the nurse will take details of your:

  • medical history and current medication
  • home intendance arrangements after you have been discharged from hospital including relative / friend support and transport arrangements

Please use this opportunity to inquire any questions most your surgery and aftercare. Yous will also be given instructions nigh preparing for your operation, which will include advice about:

  • having a bath or shower before yous come to the hospital
  • eating and drinking
  • pausing or taking your normal medication, if advisable
  • returning to piece of work later on surgery

On the solar day of admission delight bring:

  • this information leaflet
  • all medication in original containers along with the electronic printed list supplied by your doctor if available
  • dressing gown, slippers and pocket-size overnight bag / toiletries in case of overnight stay
  • contact telephone number for a lift home
  • something to read or to pass the time

Delight do not:

  • bring any valuables or wear jewellery
  • habiliment smash varnish or simulated nails
  • wear face up make upward or lipstick

What volition happen?

On the twenty-four hours of surgery

Y'all should have a bathroom or shower earlier you come to hospital.  Do not eat from ii.00am, however yous are encouraged to drink clear fluids just up to vi.00am,  e.m.no milk or pure orangish (black tea or coffee is allowed).  Chewing gum is not allowed on the day of surgery. If yous vesture contact lenses, you will need to remove them prior to your operation.  Please bring your glasses or an extra pair of contact lenses with you.

On admission to the ward you will be greeted by a nurse who will check that your details are correct.  The surgeon and the anaesthetist will talk to you and you will exist invited to ask any questions you may accept before signing your consent form. Y'all volition likewise be given graduated pinch stockings to clothing.

A member of staff volition escort you to the operating theatre.  Later the performance, you will recover in a special recovery area nigh to theatre until you are awake sufficiently to render to the ward.

What happens afterwards?

Post-obit your operation

You volition be transferred to the ward area where nurses will continue to monitor your condition.  If you experience any discomfort, please inform the nurse looking later y'all, so that hurting relief can be given.  As long equally you practice not feel sick you volition be encouraged to have something to eat or drink.

If the doctor/ nurse feels you are recovered sufficiently, you lot may exist discharged home the same day, or the following forenoon. It is of import that you arrange for someone to collect you at an appropriate time (if you have stayed overnight this will be before 11.00am).  Due to the nature of the ward you may be expected to vacate your bed early on and wait for your discharge transport in a discharge area.

Care at habitation

You volition have some mild pain for upward to a week later on the functioning. You may also take some neck and shoulder tip pain if you have had keyhole surgery. This is due to the gas used (carbon dioxide), which can get trapped and will disappear after a couple of days.

You will exist prescribed pain relief medication to have home with y'all. Please have only every bit directed. Y'all will need to continue to wear the graduated pinch stockings on your legs that were applied prior to the operation for 5 days (day and night).

You will be informed if the stitches in your wound are dissolvable or if you take stitches or skin clips that need to be removed. Some patients have Steristrips (small strips of adhesive tape) rather than stitches in their wounds. Even if you have dissolvable stitches, it is recommended that you lot have your wound checked past the do nurse 4-5 days subsequently your performance. You may shower on the day following your surgery. Any waterproof dressings over your wounds should remain in place for five days and then yous may remove them.

You should remain off work for approximately ii weeks, or as directed by the surgeon. Your surgical team will provide initial fitness for work certificates and any required extension is provided by your medico. Routine follow upwardly is not required for nearly hernia repairs unless specifically directed by your surgeon.

You should mobilise gently, gradually building upwards to normal activities; this includes sexual intercourse.  Low-cal exercise, such as walking, should exist undertaken during the showtime ii weeks. Avoid any heavy lifting for at least 6 weeks. Please wear any support corset if advised to do so by your surgeon.

Driving and Flying

Y'all should not drive until you can perform and emergency stop but please clarify this with your insurance.  This volition non be for the first 48 hours following your surgery.  Please bank check that your insurance policy does not prohibit y'all from driving for a longer period, following general anaesthetic or surgery. Based on Civil Aviation Authority guidance nosotros recommend at least 48 hours before flying later on keyhole surgery or 10 days after an open up surgical performance.

If you experience bug regarding your surgery after being discharged

PLEASE ALWAYS CALL FIRST FOR Advice

Information technology is of import you Exercise Not present yourself to the ward from where y'all were discharged.  Please telephone the ward – Mon to Fri 8.00 – 6.00pm. After 6.00pm and Weekends – contact Ward 14 Castle Hill (01482) 623014.

If yous are unable to get in touch with Ward 14 please call your GP's emergency service or 111.

Yous will receive communication over the telephone as to the advisable intendance for you. This may exist:

  • Over the telephone advice
  • to contact your doctor practice to adjust a nurse-led clinic appointment
  • an urgent outpatient clinic follow up date with your surgeon
  • to contact your medico to suit emergency admission to Hull Purple Hospital

If you are severely unwell contact your emergency physician, nourish Hull Royal Hospital Emergency Department or dial 999 for an ambulance.Castle Hill Hospital does not have on-site emergency services.

General Advice and Consent

Nearly of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before whatsoever doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a determination, you need to accept information from health professionals most the treatment or investigation which is being offered to y'all. You should e'er ask them more questions if you do non sympathise or if you want more information.

The information y'all receive should be well-nigh your status, the alternatives available to y'all, and whether it carries risks as well every bit the benefits. What is important is that your consent is genuine or valid. That means:

  • you lot must exist able to give your consent
  • you must be given plenty information to enable you to make a decision
  • you must be acting under your ain gratuitous will and not nether the strong influence of another person

Data about you

We collect and use your data to provide you with intendance and handling. As part of your care, data about you will be shared betwixt members of a healthcare team, some of whom you may not meet. Your information may also exist used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible nosotros use anonymous data.

Nosotros may pass on relevant information to other health organisations that provide you with care. All information is treated every bit strictly confidential and is not given to anyone who does non need it. If yous have whatever concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2022 nosotros are responsible for maintaining the confidentiality of whatsoever information we agree about you. For further information visit the following page: Confidential Information about Y'all.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large impress, braille or audio, due to disability, impairment or sensory loss, please suggest a fellow member of staff and this can be arranged.

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