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Nuffield Health: Worried about your hernia?

Up to 1 00,000 hernia surgeries are carried out on adults in the UK every year. Mr Dan Titcomb, a Consultant Upper GI Surge on at Nuffield Health Bristol Hospital, tells you what you need to know about hernia surgery

What is a hernia, and how is it caused?

A hernia is a protrusion of abdominal contents through a defect in the muscles of the abdominal wall. These muscles play a vital role in posture, mobility and physical exertion, and helps protect our internal abdominal organs.

Hernias may occur suddenly after a period of strenuous exertion, but in many people they may present typically as a painless bulge. Symptoms such as aching and dragging may accompany the bulging, which can feel worse as the day progresses, and is eased by rest and sleep when the bulge usually reduces in size.

The most common hernia is an inguinal hernia, which occurs in the groin, and accounts for around 70% of all hernias. Inguinal hernias also occur ten times more frequently in men than women. A hernia can often be pushed back by gentle massaging and pressure, which can improve the symptoms. However, after a fit of coughing or physical exertion, a hernia may protrude further than normal, becoming trapped, which may compromise circulation. This is known as strangulation, and requires emergency repair. For this reason, before they get to this stage, most symptomatic hernias should be considered for elective surgery.

Elective surgery dramatically reduces the risk of operative complications, and is highly successful. The recurrence rate for hernias is less than 1% in a year, and less than 5% in a patient’s lifetime.

What does surgery involve?

Most hernia operations are conducted as day case surgery, and the operation itself takes between 30-60 minutes. Most are repaired with a general anaesthetic, although in some cases they are performed under a local.

For repairing inguinal hernias, keyhole (laparoscopic) surgery is suitable in most patients, with three small incisions made beneath the umbilicus to allow access to the groin. If not suitable for this approach, a small groin incision is made, but in both operations, the contents of the hernia sack are pushed or pulled back inside the abdomen, and the area of weakened muscle is reinforced with a synthetic mesh, tacked in place with absorbable tacks or sutures.

What to expect after surgery.

The patient should feel minimal discomfort after surgery, and they usually leave hospital 4-6 hours after their operation. They will be able to eat and drink shortly after surgery, and at home, painkillers are recommended for 48 hours. Increasing amounts of light physical activity and walking will help, and most people will be able to drive and return to work two weeks later – although this may be longer for high impact jobs with heavy lifting.

If you’re worried about a hernia and would like to discuss your options, you can book an appointment with Mr Titcomb, or another of our Consultants at Nuffield Health Bristol Hospital who specialise in hernia surgery – Mr James Hewes, Mr Alan Osborne, Mr Shakeeb Khan, Mr James Hopkins and Mr Reyad Abbadi – by calling 0117 911 5339, or visit our website: nuffieldhealth.com/hospitals/bristol

Nuffield Health Bristol Hospital, 3 Clifton Hill, Bristol BS8 1BN; nuffieldhealth.com/hospitals/bristol

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