What is an incisional hernia?
 An incisional hernia is a weakness in your abdominal wall which happens at the site of a cut (incision) made during a previous operation.
How should I prepare for incisional hernia repair surgery?
Medication / supplements
You need make the surgical team aware of any medication (including alternative / complementary medicines) or diet supplements you are taking before the procedure.
Smoking
If you are a smoker, you must give up smoking 14-21 days before the procedure.
Diet
You do not need to make any changes to your diet ahead of surgery.
Exercise
Do not do any exercise that causes any pain in the area of the hernia. Otherwise you can continue with any other regular exercise regime.
Avoiding wound infection
You should avoid waxing or shaving in the area where incisions are likely to be made during surgery (your doctor or surgeon will be able to tell you where the incisions will be made). This minimises the risk of wound infection.
Hygiene
There are no specific hygiene requirements before surgery, however you should have a shower or take a bath either the night before or on the morning of the surgery.
What is involved in the procedure?
Most procedures to correct an incisional hernia are performed using laparoscopic surgery. If the laparoscopic approach is used then the procedure will generally take 1-2 hours to complete. The procedure is conducted under general anaesthesia.
Up to five very small incisions are made on the abdomen to allow access for the laparoscopic instruments and a miniature video camera and light. Any protruding tissue is moved back into place and a small piece of medical grade synthetic mesh is fixed over the weak area in the muscle wall. Once this is complete, all instruments are removed and the incision points are closed.
About 95% of these procedures are completed laparoscopically, although in around 5% of cases a laparoscopic procedure may have to convert to a conventional procedure, in which case a larger incision will need to be made at the site of the hernia to allow the surgeon to directly visualise the operating area and complete the surgery.
Recovery Guidance
Hospital stay
Most patients undergoing this procedure are able to return home the day after surgery, or on the second day after surgery.
After the procedure you will still be affected by the anaesthetic. This may temporarily cause the following symptoms:
- Dizziness.
- Blurred vision.
- Short term memory loss.
- Nausea.
- Vomiting.
- Sore throat.
- Pain.
This is why it is very important that you do not, during the 24-hour period after the procedure:
- Drive (you must have someone available to drive you home after the procedure).
- Operate dangerous machinery.
- Drink any alcohol.
- Sign any legal documents.
- Make any important decisions.
Pain management
There is often moderate to severe pain after this procedure. There may be some pain once the effects of the local anaesthetic have worn off around two hours after the procedure.
If this is the case we recommend the following combination of Panadol and Ibuprofen for the initial 48-hour period after surgery:
- Two (500mg) Paracetamol tablets every four to six (4-6) hours.
- Two (200mg) Ibuprofen tablets every six to eight (6-8) hours.
If pain continues beyond this period, or if it becomes severe, you should contact your doctor.
In rare cases, this pain relief may not be sufficient – in which case you will need to take stronger pain relief. You will require a prescription for Panadeine Forte – two (500mg) tablets every six to eight (6-8) hours.
Two things to be aware of with pain medication – firstly ensure that you can take medicine containing ibuprofen, such as Nurofen (if you do not know you should check with your doctor) and secondly be aware that Panadeine Forte will make you drowsy and cause constipation.
Wound management
All incisions made during surgery will be covered with a waterproof dressing. Under this is a row of Steri-Strips. The outer dressing can be removed 48 hours after surgery. The Steri Strips should not need to be removed as they will come off naturally. No stitches need to be removed. You are able to shower with the waterproof dressing on.
Returning to normal activity
The following is general information, although it is a good idea to be guided by any pain during specific activities and ease off if pain continues. Hernia recurrence may result if physical activity is taken up too soon.
5-7 Days After Surgery
General activities, including work (light duties) can be commenced at this point. You should not drive until this point.
14-21 Days After Surgery
Sport and general exercise can be resumed at this point (after laparoscopic surgery).
35-42 Days After Surgery
Sport and general exercise can be resumed at this point (after open surgery).
Risks / complications
There are risks associated with all surgical procedures, such as wound infection, and risks relating to anaesthesia and bleeding during the procedure.
The risks / complications specific to surgery to correct an incisional hernia include:
- Haematoma (blood clot).
- Bleeding.
- Recurrence of hernia.
- Difficulty passing urine.
Dr Silverman will be able to discuss any possible risks or complications with you well ahead of the procedure.
When to contact Dr Silverman
You should contact Dr Silverman if you experience any of the following symptoms post surgery:
- Feeling faint or dizzy.
- Increasing pain.
- Severe pain when moving around / breathing / coughing.
- Fever/elevated temperature.
- Absence of bowel movement.
- Swelling of the abdomen.
- Trouble urinating.
- Nausea.
- Lack of appetite (particularly if this persists beyond the 48-hour mark after the procedure).