Inguinal hernia

Abdominal hernias are the result of abdominal organs or tissues protruding through natural holes or defects in the abdominal walls.

CAUSES:

• abnormal collagen synthesis and maturation
• increased abdominal press activity
• abdominal surgical operations

SYMPTOMS:

• abdominal integument bulging
• pain
• bowel movement abnormality

COMPLICATIONS:

• hernia incarceration being life threatening 

TYPES OF HERNIAS:

• inguinal hernia
• umbilical hernia
• epigastric
• incisional

TREATMENT

Surgically, using own tissues or synthetic material (special mesh, currently partially absorbable)

PREPARATION FOR TREATMENT:

Test

• complete blood count
• APTT (blood coagulation)
• electrolytes
• blood type
• general urine test
• ECG (compulsory for 40+ patients)
• Chest x-ray ( current image, taken less than 6 months prior to the planned procedure)
• all additional tests recommended by a doctor during consultations
• complete medical history for resolved and chronic diseases
• additional tests may be requested to ascertain current state of health, e.g. in the event of thyroid disorders current TSH, FT3 and FT4 tests are required. A consultation with a different doctor (e.g. a cardiologist for chronic heart diseases). On the day of the surgery please arrive at ART MEDICAL CENTER with the results of all prescribed tests and full medical history.

RECOMMENDATIONS

• If you are a smoker it would be beneficial not to smoke for six weeks prior to the surgery, as smoking tobacco reduces tissue blood flow and respiratory efficiency increasing surgical risk and inhibits healing
• 30 days before the planned surgery it may be required to discontinue hormone replacement therapy or contraception pills (in consultation with the prescribing doctor).
• 10 days prior to the surgery medication containing acetylsalicylic acid should be discontinued (e.g. Acard, Aesan, Aspirin, Polopiryna), acenocoumarol preparations (e.g. Acenokumarol, Syncumar, Sintrom, Warfin) as these types of medications increase the risk of excessive bleeding during and post surgery increasing the risk of complications occurring. If needed they may be replaced with low-molecular-weight heparins
• For 14 days prior to the surgery avoid sunbathing and sunbeds as than may leads to skin inflammations, burns and increase infection susceptibility.
• On the day of the surgical procedure (5 hours prior to the surgery) refrain from eating, drinking or chewing gum. Do not wear makeup or jewellery when coming for the surgery. Loose and comfortable attire will be convenient during the stay at AMC and the return journey.
• Shave or remove bodyhair in the area to be treated on the day of the surgery

Inguinal hernia - procedure under spinal anaesthesia

Surgery stages:

1. Incision in the groin area
2. Hernial sac preparation
3. Reinforcing the rear wall of the inguinal canal using own tissue (Shouldice technique) or using a synthetic material (Lichtenstein technique)

POSSIBLE COMPLICATIONS:

• Damage to spermatic cord elements (vas deferens, testicular vain and artery) sometimes requiring testicle removal
• Damage to the small or large intestine
• Bladder damage
• Haematoma
• Infection, which if a mesh was used may require its removal
• Thigmesthesia disorders in the operated area
• Recurrence of hernias
• Hypertrophic scars

AFTER THE SURGERY 

You may feel some discomfort in the operated area, but there should be little pain. Pain killers will be administered to alleviate the ailments.

Sometimes a drain is left in the operated area after the surgery

Patients are usually discharged within 24 hours after the operation

Sutures removed after 7 days at the Clinic

RECOVERY

Return to normal functioning after 2 - 4 weeks

No lifting above 5 kg for 6 months

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