Hernia Repair

Mr Haddawi will examine your hernia in clinic before deciding the best course of action for treatment. Laparoscopic repair, while the preferred for most, may not be suitable for everyone for a number of reasons (such as major scarring from previous surgery, bleeding disorders, pregnancy, and the inability to have a general anaesthetic).

In some cases, Mr Haddawi may find that it is unsafe to continue laparoscopically due to unexpected problems. In these instances he may have to convert to an open surgery. While this is disappointing, this decision is not made lightly and keeps your best interests of safety and well-being in mind.

Mr Haddawi typically uses a high-grade surgical mesh to repair your hernia and reduce the risk of recurrence. Certain patients may not be suited to the mesh, and Mr Haddawi can discuss this with you.

Hernia repair is typically performed under general anaesthesia. However, if this is not suited to you, open repair may be done under regional anaesthesia.

Laparoscopic repair can be used to treat many types of hernia. This is performed through several small incisions in the abdomen. A laparoscope (thin, telescope-like camera) is inserted through a small incision close to the bellybutton. This allows Mr Haddawi to view the hernia on a screen. Carbon dioxide gas is then blown into the abdomen, allowing for space to improve the view and access to the area. The hernia is then repaired with the mesh, instruments are removed from the abdomen, and the carbon dioxide gas is allowed to escape. 

Stitches or clips close the small incisions, which are then protected with small dressings.

After this procedure, you may have temporary discomfort in either shoulder. This is normal, and from the carbon dioxide gas used during surgery. Most people can go home the same day as their procedure or the next morning.

Mr Haddawi performs this surgery by making an incision at the site of the hernia. Protruding tissue and organs are pushed back into the abdominal cavity, and the abdominal muscles are stitched together to repair the defect. Surgical mesh is placed over or under the muscles to add support, and prevent recurrence. 

The incision is then closed with sutures and protected with a glue.

You may go home the same day as your procedure if you had a regional anaesthetic. A general anaesthetic with open repair usually requires a one-night stay in hospital.

Immediately after your surgery, you may have some pain around the incision and need pain relief. Swelling and bruising are common, and may extend towards surrounding areas. If you are not nauseous, you will be able to drink water and eat a light meal a few hours after surgery. You will be asked to take a short walk soon after your surgery to prevent blood clots from forming in your legs.

Recovering at home may take 1-2 weeks. Mr Haddawi will advise you on suitable activity levels after your procedure. Men may find relief in wearing scrotal-support or jockey-style underwear. It is normal to feel twinges or odd sensations at the area operated on in the 4-6 weeks following your procedure.

You can help yourself with a comfortable recovery by observing the following:

• No heavy lifting or vigorous exercise until advised by Mr Haddawi
• Follow advice given on showering, driving, and returning to work.
• Be weary that pain medications can cause constipation and temporary changes in bowel habits.

Fluid accumulation in the wound, known as a seroma, may occur after certain types of hernias after hernia repair. This is not a complication of the surgery, but may need to be drained with a syringe.

Mr Haddawi will usually see you at Mana Clinic 2-3 weeks after your procedure for a follow-up.

As with any surgical procedure, there is a small chance of experiencing complications after undergoing hernia repair. Mr Haddawi works with you closely to ensure any risks are mitigated as much as possible. 

General risks of hernia repair include:

• A recurrence of the hernia.
• Cardiovascular problems (such as blood clots). This risk is decreased by wearing compressive stockings, and walking soon and often after your procedure.
• Infection of the wound. This is more likely to occur with open repair, in people with diabetes, and in people taking immunosuppressants such as prednisone or prednisolone. You will receive IV antibiotics as a precaution.
• A hypertrophic or keloid scar, which is raised and irregularly-shaped. Most incisions heal very well, and while a hypertrophic scar can be itchy and annoying, it is not a health threat and often resolves on its own.

• Chronic pain, due to the involvement of a nerve in the repair.
• Rarely, in men, blood supply to a testicle may be affected after groin hernia repair.

Specific risks to a laparoscopic repair (all are rare) include:

• Injury to an organ near the hernia site (such as the intestines or bladder).
• Injury to blood vessels.
• Nerve injury from staples that attach surgical mesh to muscle tissue.
• Scrotal swelling due to gas/fluid collection, resolves spontaneously
• A new hernia at one of the small incisions.