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Outpatients/Day Surgery Centre Your laparoscopic inguinal hernia operation patientinformation Rotherham Hospital Your health, your choice, our passion
What is a hernia? A hernia is a bulge or weakness in the muscles that form the front of the body wall. An inguinal hernia is in the groin. They can be on either sides and can be present from birth. Sometimes, they develop later in life due to overstraining by persistant coughing, heavy lifting strenuous sports etc. Hernias are fairly common and left untreated can get bigger, cause pain and occasionally cause a blockage of the bowel. What does the operation consist of? Your hernia is to be repaired using keyhole (laparoscopic) surgery. The operation is performed under general anaesthetic (you will be asleep) and the hernia is repaired using nylon mesh and stitches from inside the abdomen using special instruments. Only 3 small cuts, less than 1cm are made on your abdomen near the umbilicus (belly button). There is no need for a 10 to 12cm cut over the hernia in the groin. 3
How long will I be in hospital? The operation can be done as a day case depending on your health and the majority of patients quickly return to their normal activities. Requirements for a day case l No health problems requiring an overnight stay (your pre-assessment nurse or anaesthetist will determine this) l A responsible adult to take you home by car l A responsible adult to stay with you for 24 hours after your operation Are there any alternatives? Traditionally inguinal hernias have been repaired with a nylon mesh and stitches via a cut in the groin over the hernia (open method). This is still a good method of repair, but patients who undergo the keyhole operation have less post-operative pain, avoid a large cut in the groin and recover faster then patients who undergo the traditional open operation. Simply waiting and seeing if you have more trouble is not usually a good idea. The hernia will generally get worse. A truss can be worn and may hold the hernia in. It may be useful as a stop-gap until you have the operation. It should be used as an alternative if you do not like the idea of an operation or if you are not well enough for an operation. 4
What happens before the operation? You will be welcomed by the receptionist. You will have your details checked and the nurse will check your pulse, temperature, blood pressure and that nothing has changed since pre-assessment and that you are appropriately starved. You will be seen by the surgeon who will be doing the operation. The operation will be explained to you and you will be asked to sign your consent form for the operation, if you have not done so already. If you are not clear about any part of the operation, please ask for more details. You will also be seen by the anaesthetist to check your health and to discuss your anaesthetic and pain relief. Will I have any pain after the operation? You will be given painkillers by your anaesthetist while you are asleep. There may be some discomfort in the abdomen or groin on moving. Simple painkillers should control this discomfort. If not, the nurse can give you stronger painkillers if needed. You will be expected to get out of bed despite the discomfort. You will not do any harm and the exercise is helpful for you. By the end of week one the wound should be virtually pain free. Please take you painkillers regularly for the first 48 to 72 hours to keep the pain under control, rather than trying to treat it when it hurts. 5
Drinking and eating You will be able to eat and drink within an hour of the operation, providing you are not feeling sick. The wound and stitches The wounds have dressings, which may show some staining with blood in the first 24 hours. The wounds will be covered with plastic dressings that allow you to shower. If there are stitches in the wounds you will need to arrange to have them removed by your practice nurse about a week after your operation. This will be discussed on the day of surgery. There may be some purple bruising around the wounds that fades to a yellow colour after 2 to 3 days. There is often some mild swelling/bruising of the area where the hernia was or the scrotum (especially if the hernia was large), which also improves in a few days. Washing You can wash or shower after 48 hours, the dressings are only shower proof. They will not stay on in the bath. 6 Recovering at home After you leave hospital you are likely to feel tired when you get home, but this will gradually improve so that after 1 to 2 weeks, you will be able to return completely to your usual level of activity. You can restart sexual relations as soon as you wish.
Lifting Please be careful when lifting. At first discomfort in the wounds should prevent you from lifting something too heavy and harming yourself. After one month you can lift whatever you like. There is no value in attempting to speed the recovery by special exercises. Driving You can drive as soon as you can make an emergency stop without discomfort in the wounds, usually within a week. Work You should be able to return to a light job after about 1 week and any heavy job within 2 weeks. Are there any side effects? Side effects are mostly mild and temporary. l You may feel sick as a result of the general anaesthetic or painkillers. Medicines are available to help avoid this. l There may be some soreness in the abdomen l Possibly some pain in the shoulders, especially the right shoulder and the upper right part of the abdomen. This is caused by the gas that is used to inflate he abdomen. This usually settles within 24 hours l Bruising and swelling around the groin area or scrotum is common, if the hernia was large. The swelling may take 2 weeks to settle down 7
Complications Complications are unexpected problems that can occur during or after the procedure. Most people are not affected. However, complications of any operation are: l Damage to organs or blood vessels in the abdomen l Excessive bleeding l Conversion to an open operation l Wound infection l Swelling of the scrotum l Aches and twinges may be felt in the wound or groin for up to 6 months l The risk of reoccurrence of the hernia is about 2%. l Developing a blood clot, usually in a vein in the leg (deep vein thrombosis DVT) most people are asked to wear compression stockings to help maintain the blood flow in the veins of the legs during and after the procedure. l An abnormal reaction to anaesthetic 8
If you notice any of the following symptoms you should contact the hospital. l Any of the wounds start to bleed l Any of the wounds become more painful, red, inflamed or swollen l Your abdomen swells l Your pain is not relieved by the prescribed painkillers l A fever develops If you are worried about your condition, telephone Day Surgery Centre on 01709 426500 and ask to speak to a nurse. After 8.00pm at night or at weekends please contact the number on your discharge letter. 9
Useful contact numbers NHS Direct Telephone 0845 4647 Patient Services Telephone 01709 4274461 Freephone 0800 9531303 Health Info Telephone 01709 427190 Quit Smoking Service Telephone 01709 422444 For GP out of hours, contact your surgery Useful websites www.nhs.uk www.direct.gov.uk www.therotherhamft.nhs.uk If you require this document in another language, large print, braille or audio version, please contact Big Word on 0800 8620625 or email patientinformation@rothgen.nhs.uk 10 Produced by Mr Cooper, September 2005. Revised April 2008, September 2010 by Dr K Russon & Mr Cooper Revision due September 2012. Version: 3.0 The Rotherham NHS Foundation Trust 2010. All rights reserved.
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