Hernia Surgery
Laparoscopic inguinal hernia surgery is a proven technique, which is suitable for the management of most groin hernias. Long-term cure rates of 99% are achieved with most patients having little or no pain. Surgery is performed via 3 small puncture wounds in the lower abdomen. The defect in the abdominal wall muscles is covered by a sheet of synthetic permanent mesh. Patients return to office type work within 5-7 days and are able to resume all physical activities within 4 weeks.
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Inguinal or Femoral Hernia Discharge instructions
You have recently had surgery for an inguinal or femoral hernia.
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Postoperative instructions
The following information is intended as a guide for patients who have undergone laparoscopic or open inguinal hernia surgery. Laparoscopic inguinal hernia surgery is performed via three (3) small incisions in the lower abdomen, while open surgery is performed via a single larger groin incision.
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Dressings
Your wounds are covered with an outer waterproof dressing . You can shower normally with these dressings in place. The dressings can be removed after 7 days . There are no stitches to be removed.
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Bruising of the penis and scrotum is common and resolves within a few weeks. Some patients develop a hard swelling at the site of the hernia repair. This is usually a simple fluid collection, which resolves after a few weeks.
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Pain relief
It is normal to have significant pain for the first few days after surgery. This is best treated with a combination of Panadol two (2) tablets every 4-6 hours and Nurofen two (2) tablets every 8 hours. It is unusual to require stronger analgesics. Palexia IR or Endone can be used as per a prescription for more severe pain, but these may be both sedating and constipating.
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Driving
You should not drive for five (5) days after surgery.
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Work
Most people are fit to resume sedentary occupations after 5-7 days. If your job involves more physical demands you should discuss this specifically with your doctor.
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Physical activity and sport
Patients having laparoscopic inguinal hernia surgery may return to regular sport and physical activity within 2-3 weeks. Pain should be used as a guide to determine what can or cannot be undertaken. Recovery is slower after open inguinal hernia surgery. Most patients are able to resume full physical activities within 5-6 weeks. Premature return to sport or vigorous physical activity risks development of a recurrent hernia.
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Sexual Function
Inguinal hernia surgery does not affect sexual function. Men may experience temporary aching in the scrotum for 2-3 weeks after surgery. It is safe to resume sexual relationships within 1-2 weeks of surgery.
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Mesh Repair Umbilical Hernia Post Operative Instructions
You have just had a mesh repair of an umbilical hernia. Currently there is a bulky pressure dressing in place. This should be left in place overnight to prevent bruising. The pressure dressing can be removed the morning after surgery. Beneath this is a waterproof dressing. You can shower with this dressing in place. It should be removed after 5 days. There are then no stitches to remove.
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If there is fluid or blood collecting beneath the dressing you may remove the dressing and replace it with another waterproof dressing. These can be purchased at your pharmacy.
Most patients are quite sore after this surgery. You will be given painkillers to take home with you. You should take these regularly for the first 48 hours or so. You should not drive for four days after the surgery. You can walk around as much as you like but you should not undertake any heavy physical activities for six weeks.
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It is important to be aware of signs of infection, which can develop after any surgery. These include redness, heat, pain or swelling at the surgical site. If any of these signs develop you should contact your surgeon.
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It is normal to feel a hard lump below the umbilicus and often extending a few centimetres above and below, and to the sides. This is part of the normal inflammatory reaction to surgery.
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You will need to make a post-operative appointment to see your surgeon in four weeks.
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Postoperative Instructions
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Pain Relief
Local anaesthetic has been used to provide pain relief today but this will wear off over the next few hours. It is important to take some painkillers before the pain becomes intense, as it will then be harder to control. Unless otherwise directed you should use Panadol 1 gram every six hours and Ibupfrofen 400 milligrams every eight hours for the next 48 hours. You should check with your doctor that it is appropriate for you to take Ibupfrofen. If you require stronger pain relief Endone 5 milligram may be used but this will require a prescription. You must not drive or work while using this medication.
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Dressings
Wounds around the anus cannot be stitched closed because of the risk of infection. As a result you may have an open wound, which will have been dressed in the operating theatre. If a dressing has been used this can be easily removed in the bath or shower later that day. Unless otherwise instructed, the wound requires no dressing, and you should wear a pad inside your underwear to absorb any fluid leaking from the wound. These secretions can irritate the skin around the anus. This can be prevented by using a barrier cream like Bepanthen or Vaseline.
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Bowel Movements
Your bowels will continue to work normally after your surgery. It is best to avoid becoming constipated, as hard motions will increase you level of discomfort. Normafibe, one teaspoon twice daily may be used for the first week after surgery. It is normal to experience pain with bowel movements for the first week or so after surgery. You may see blood on the toilet paper or in then bowl with the first few bowel motions.
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Salt Baths
Warm baths are very soothing when you are in pain. A handful of cooking salt may be added to the bathwater in order to help keep the wound clean. If you find it helpful you can bathe 2–3 times per day and after bowel movements.
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Things to watch out for
If you experience high fevers, large volume bleeding, difficulty passing urine or increasing pain, you should notify your doctor as soon as practicable.
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Resuming normal activities
Anal surgery is painful. Except after very minor procedures, you will need 5–14 days off work. Sport and vigorous physical activities should be avoided for 2–3 weeks.