General, upper GI and advanced laparoscopic surgery
Mr Andrew R DaviesBSc (Hons) MBChB MSc MD FRCS
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Inguinal Hernia Surgery in London

What is an inguinal hernia?

Inguinal hernia are the most common type of hernia. They can be the result of a defect from birth or due to a weakness developing over time. They are best described as a swelling in the groin area, which is more prominent on standing or straining. The hernias usually disappear on lying down.

Hernias, which do not cause symptoms, do not always need to be fixed. However, in younger patients it is likely they will become symptomatic with time.

In larger hernias, the swelling may contain bowel. There is a small risk of part of the bowel becoming trapped or damaged within the hernia. In males, the hernia can extend into the scrotum. Large hernias should be repaired and if very symptomatic should be fixed urgently.

inguinal hernia surgery LondonSurgical hernia repair –

The LSG specializes in inguinal hernia surgery in London. Repair involves using a synthetic mesh to reinforce the tissues. This can be done with either open or keyhole surgery depending on the size, type and location of the defect. Patients with hernias on both sides will be preferentially fixed with keyhole surgery.

Laparoscopic (keyhole) repair – Three small cuts are made in the abdominal wall to allow the passage of the instruments. The hernia is repaired using synthetic mesh and keyhole fixation devices. The cuts are repaired with dissolvable sutures and a local anaesthetic is given. A waterproof dressing is placed over the sites so you can shower straight away. These should be left for 3 days. On removal if the wound is not dry another dressing should be applied for a few more days.

More information on Laparoscopic Surgery

Open hernia repair – This technique is often used in either very small uncomplicated hernias or in very large defects when the hernia extends into the scrotum. In large hernia repairs, the recovery time can be longer and will be dependent on the type of repair required. Your surgeon will discuss this with you, as it will vary on a case-by-case basis. Again dissolvable sutures are used and a waterproof dressing placed over the wound. For open repair of small hernias there is minimal difference in recovery time from keyhole surgery. A small incision is made and recovery time should be short.

For a recent article on the use of mesh in hernia repair click here.

What happens prior to surgery?

The secretary and hospital will organise a day for the procedure and give you the admission details. Routine blood tests and a heart tracing (ECG), maybe required before admission. You will be asked not have anything to eat up to six hours prior to surgery. Water can be taken up to 2 hours prior to the surgery. The surgeon will go through the procedure again with you on the day and take your consent. The anaesthestist will also visit to discuss the general anaesthetic and your post surgery pain relief. It is also not uncommon for patients to require anti-sickness medications after a general anaesthetic.

How long will it take for me to recover from surgery?

Straight forward hernia repair is usually performed as a day procedure. If the procedure is carried out late in the day or if there are any other medical concerns then an overnight stay maybe required. You will be discharged once you are fully mobile, passed urine and comfortable. Most patients require 2-3 days of simple pain medication but should be fully functional during this period. Some patients return to work after this, but it will depend on the type of repair and your occupation.

Where is inguinal hernia surgery performed

The LSG performs inguinal hernia surgery in London (London Bridge), Surrey and Hampshire (Clare Park hospital). Please contact the practice secretary for details.

Which medications will I require after surgery?

You will be discharged from hospital with a supply of simple painkillers with instructions on how to use them. Regular paracetamol is particularly effective and can be combined with an anti-inflammatory drug (ibuprofen) or a codeine based drug (dihydrocodeine). Anti-inflammatories are not suitable for all patients and should be taken with food. The codeine-based drugs can cause constipation and should be taken with plenty of fluids. Most patients do not require painkillers after 5 days.

When can I return to work?

Generally it is recommended to take two weeks off after surgery. Your ability to return to work will depend on your job and varies between individuals. Patients can often return to work a week after surgery if required. We would not recommend flying immediately after surgery. This should be discussed on a case-by-case basis with the consultant.

When can I return to normal activities?

There are usually no restrictions on lifestyle or activities after a hernia has been repaired once recovery is complete. Strenuous activities (gym) should be avoided for 6 weeks.

When can I drive?

Driving should be avoided in the first week after surgery. Once you can perform an emergency stop in a stationary vehicle and turn to view your blind spot then driving should be safe. It is preferable to contact your insurance company to check for any specific instructions they may have.

What are the risks?

Straightforward repair carries a very low risk of the hernia returning. There maybe some numbness in the region of the scar. There should be no effect on sexual or urinary function. In complicated cases for recurrent hernias or very large hernias, there is a small risk to the testicle on the side of the hernia. Your consultant will discuss this with you. A small number of patients develop chronic discomfort in the groin after repair. This could be the result of nerve entrapment or irritation from the mesh. We tend to use lightweight meshes to avoid this and dissolvable fixation devices.

Who do I contact if there are concerns?

The group practice telephone is answered in working hours and messages can be left out of hours. Any concerns will be relayed directly to one of the consultant surgeons on receipt. The hospital ward also provides a 24/7 means of contact. They will contact the consultant about any concerns and are able to give advice if required.

For more information on inguinal hernia surgery in London, or inguinal hernia surgery in Surrey please contact us on info@londonsurgicalgroup.co.uk