Open Inguinal Hernia Repair

Open inguinal hernia repair is an operation performed to repair an inguinal hernia. The operation is performed under a general anaesthetic (fully asleep). Antibiotics are given to minimise the risk of wound infection. An incision in the groin is made over the area where the hernia is located. The tissues are dissected down to the hernia sac which is opened to inspect the contents (usually fat or bowel, sometimes bladder). The contents are replaced into the abdominal cavity and the sac removed or closed. A mesh plug is placed over the hernia defect in the muscles and sutured in place. Abdominal muscles are then closed with dissolvable sutures. The skin incision is sutured with dissolvable stitches under the skin and dressings are placed.

What to expect post-operatively

Hospital stay

Most people spend one night in the hospital and can be discharged in the morning following the surgery.

Recovery

Most people recover well and reasonably quickly and feel almost back to normal within 2 – 4 weeks. It is normal to have groin swelling and bruising and this can be particularly apparent in the scrotum in males. Usually, people require 1 – 2 weeks off work but this can be longer if one has a physical job.

Pain

Pain is usually well controlled with simple painkillers. You should take regular analgesia in the first 48 hours including paracetamol (Panadol) 1g (2 tabs) every 4-6 hours (max 8 tabs per day) and an anti-inflammatory such as ibuprofen (Nurofen) 400mg every 4 – 6 hours. You may be given a prescription for a stronger painkiller such as oxycodone (and one) or tramadol (tramadol) to use also as well. After 48 hours, use the painkillers only if needed.

Wounds

The wound will be closed with dissolvable stitches that are underneath the skin and therefore don’t need removing. The stitches can take months to fully dissolve. A dressing will be placed over the wound. Leave this on for 1 week. You can wash or shower with these water-proof dressings. Once the dressing is removed, leave the wound open to the air unless it is still discharging fluid.

Exercise

Don’t do any strenuous activities for 4 weeks. Don’t lift anything over 1-2kg during this time. Walking and normal activities around the house are encouraged if you feel comfortable enough. After 4 weeks, you can start doing more strenuous activities if there is no pain or discomfort.

Complications

• Bleeding – Bruising and swelling is common, significant bleeding is very rare.
• Infection – Uncommonly, the wound can get infected. This can usually be treated with antibiotics.
• Seroma – This is when there is a collection of tissue fluid under the wound. This may need drainage with a needle, sometimes on several occasions.
• Chronic pain – In all hernia surgery, there is a small proportion of people who have pain in the groin continuing after 6 weeks. There are a variety of causes for this. Most chronic pain resolves with time. Occasionally, medications or other interventions are needed to help with the pain.
• Mesh infection – with modern meshes, this is extremely rare. If mesh infection occurs and antibiotics don’t control it, the mesh needs to be removed.
• Hernia recurrence – the recurrence rate is approximately 1 – 2%.