If you have surgery with The Hernia Clinic, Mr Coombs will advise you of the best method of hernia repair. You will be offered a follow-up appointment to seen in a clinic about a fortnight after surgery for a check up and consultation.
Usually absorbable sutures will be used to close the skin, and the scar protected with a waterproof dressing. This will allow you to shower on the day of surgery (but no soaking in a bath until ten days). The dressings may be peeled off after ten days.
There is often a little “thickening” of the scar in the first few weeks after surgery. This is the body’s reaction to the absorbable suture. Gentle rubbing with a body wash whilst showering will help this to settle.
For some patients a simple suture repair using permanent internal sutures may be used. However, for other patients a mesh is placed to act as a reinforcing layer within the abdominal wall. All surgical operations aim to cover the hole (defect) in the muscles of the abdomen. Whilst the sutures and mesh are strong materials, it is the body’s own scar tissue that causes the strongest repair and it is this healing tissue that anchors the mesh and sutures in place. This process starts as soon as the operation has finished but will take at least six weeks to gain full strength.
If excessive activity is attempted before six weeks then there is the risk that the scar tissue may separate from the mesh and sutures. This could expose or tear the very hole that is meant to be covered, and the hernia might recur.
As a “rule of thumb” – “in the first month, if you can’t lift it easily with one hand, you shouldn’t lift it at all”.
In the first few days you should take gentle exercise (walking) as stiffness permits. After a month you can start more demanding exercise although you must build up to full strength gradually. Most people need one week off work after a laparoscopic hernia operation. Patients with strenuous manual work may need 4-6 weeks before they can return to full duties.
Do not drive for 24 hours after a general anaesthetic. You need to be able to perform an emergency stop without pain to drive safely. The time for this varies from patient to patient and can depend on the hernia type and method of repair used. Most patients can drive a week or two after their hernia operation.
Some hernia operations are more complex than others. Mr Coombs will advise what stretching exercise might be suitable for you.