What can I expect during the procedure?
In the anaesthetic bay of the operating theatre a small plastic tube (called a cannula) will be placed into a vein in your arm or hand. If the procedure is being done under general anaesthetic, the cannula is used to administer intravenous sedation, which is the first stage of your anaesthetic. Once it has taken effect, you'll be taken to the operating theatre.
Hernia
The procedure will differ based on the type and location of the hernia, and to some extent the preference of the surgeon. There are two main types of operation: laparoscopic (keyhole), and open repair. Laparoscopic repair is often (although not exclusively) used for inguinal and incisional hernias.
Inguinal Hernia repair
Open repair
An incision is made directly over the hernia and down through the outer layer of the abdominal wall and muscle. Modern open hernia repair is done through a relatively small incision and can even be done under local anaesthesia. The surgeon often uses mesh to repair the defect. This mesh is placed between the layers of the abdominal wall, not deep in the pelvis or inside the abdomen, as is done in the laparoscopic (keyhole) approach.
Laparoscopic repair
Three small cuts are made in the wall of the abdomen. A balloon dilating apparatus is put in and moved down to the pubic bone between the abdominal muscles and stomach lining.
The balloon is inflated to separate the lining from the layer of muscle. It’s then removed and replaced with a tube (called a laparoscopic port). The area is expanded with water and a telescope is put into the space.
Two more incisions are made on the opposite side of the hernia, between the umbilicus and pubic bone, to make room for the surgical instruments. A space is created so the defect of the muscle can be seen clearly.
The hernia is then pulled back into the space and a piece of flexible mesh is guided down the port and put in place to cover the weak areas. The mesh is held in place by around 10 tacking devices.
Anaesthetic is put into the space before the surgeon withdraws the ports. The small incisions are then closed with dissolving stitches.
The pressure in the cavity of the abdomen pushes onto the mesh and traps it, holding it in place. With any straining or increase in pressure in the abdomen, the mesh is pressed firmly against the abdominal wall, helping to stop the repair pulling apart.
Ventral incisional hernia repair
Open repair or laparoscopic
An incision is made through the skin, outer layer of the abdominal wall and muscle overlying the area. The size of the incision depends on the size and position of the hernia.
As with the laparoscopic technique, your surgeon will usually use a mesh to reinforce the weak abdominal wall. This is stitched or stapled into place without tension and is therefore known as a tension-free repair. Older techniques involved tightly stitching together the area, which lead to longer recovery times and a higher rate of hernia recurrence.
Hydrocoele
The area of the groin is cleaned with an antiseptic solution. A small incision is made in the groin on the side of the hydrocoele. The blood vessel leading to the testis and the tube that carries sperm from the testicle to the penis are freed up from the surrounding tissues. The pocket of abdominal lining is separated out and tied off. The fluid is then drained from around the testis.
The other tissues are returned to their normal position and the wound is sutured closed under the skin. In most cases absorbable sutures are used. The wound is then covered with a water-resistant dressing.
Open repair
An incision is made through the skin, outer layer of the abdominal wall and muscle overlying the area. The size of the incision depends on the size and position of the hernia.
As with the laparoscopic technique, your surgeon will usually use a mesh to reinforce the weak abdominal wall. This is stitched or stapled into place without tension, and is therefore known as a tension-free repair. Older techniques involved tightly stitching together the area, which lead to longer recovery times and a higher rate of hernia recurrence.
Hydrocoele
The area of the groin is cleaned with an antiseptic solution. A small incision is made in the groin on the side of the hydrocoele. The blood vessel leading to the testis and the tube that carries sperm from the testicle to the penis are freed up from the surrounding tissues. The pocket of abdominal lining is separated out and tied off. The fluid is then drained from around the testis.
The other tissues are returned to their normal position and the wound is sutured closed under the skin. In most cases absorbable sutures are used. The wound is then covered with a water-resistant dressing.
IMPORTANT INFORMATION
Information is provided by HCF in good faith for the convenience of members. It is not an endorsement or recommendation of any form of treatment nor is it a substitute for medical advice, and you should rely on the advice of your treating doctors in relation to all matters concerning your health. Every effort has been taken to ensure the accuracy of the information, however HCF takes no responsibility for any injury, loss, damage or other consequences of the use of this information.