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Hernia Surgery

 

Mr Ahmad has an extensive experience in hernia surgery including, groin hernias (inguinal and Femoral), umbilical hernias, epigastric hernias and incisional hernia. Mr Ahmad has performed more than 2000 hernia procedures. He uses open minimally invasive techniques for his hernia repair.

Hernia Surgery is one of the most common surgical procedures performed in the United Kingdom. Many surgeries are performed using the conventional “open” method. However, a few hernia surgeries are performed using a small telescope known as a laparoscope.

Your doctor will discuss the pros and cons of each of the approaches in detail at the time of your first consultation.

What is a hernia?

A hernia occurs when the inside layers of the abdominal muscle have weakened, resulting in a bulge or tear.

In the same way that an inner tube pushes through a damaged tire, the inner lining of the abdomen pushes through the weakened area of the abdominal wall to form a small balloon-like sac.

This can allow a loop of intestine or abdominal tissue to push into the sac. The hernia can cause severe pain and other potentially serious problems that could require emergency surgery. Both men and women can get a hernia. 
You may be born with a hernia (congenital) or develop one over time.

However, a hernia does not get better over time, nor will it go away by itself.

How do I know if I have a hernia?

The common areas where hernias occur are in the groin (inguinal), belly button (umbilical), and the site of a previous operation (incisional).

It is usually easy to recognize a hernia. You may notice a bulge under the skin. You may feel pain when you lift heavy objects, cough, strain during urination or bowel movements, or during prolonged standing or sitting.

The pain may be sharp and immediate or a dull ache that gets worse toward the end of the day. Severe, continuous pain, redness, and tenderness are signs that the hernia may be entrapped or strangulated.

These symptoms are cause for concern and immediate contact of your GP/A&E.

Surgical options of hernia repair:

  • Open conventional repair
  • Minimal access repair/Plug repair (Mr. Ahmad’s special interest and specialty)
  • Laparoscopic repair (mostly beneficial in bilateral inguinal hernias)

The conventional open approach, applicable to all hernias, i.e. inguinal, femoral, umbilical and incisional, is done from the outside through a three to four inch incision in the groin or the area of the hernia.

The incision will extend through the skin and subcutaneous fat, and allow the surgeon to get to the level of the defect. The surgeon may choose to use a small piece of surgical mesh to repair the defect or hole.

This technique is usually done with a local anesthetic and sedation but may be performed using a spinal or general anaesthetic.

Minimal access/plug repair: this technique can be used for all groin and umbilical hernias. It is usually performed under local anaesthesia, has the advantage of a small incision and hence minimal discomfort.

Mr. Ahmad has extensive experience in hernia surgery and most of his patients will have minimal discomfort after this procedure.

Laparoscopic hernia repair:

Laparoscopic hernia repair is a technique to fix tears in the abdominal wall (muscle) using small incisions, telescopes and a patch (mesh). It may offer a quicker return to work and normal activities, with decreased pain for some patients.

How is the procedure performed?

There are few options available for a patient who has a hernia. Use of a truss (hernia belt) is rarely prescribed, as it is usually ineffective. Most hernias require a surgical procedure. Surgical procedures are done in one of two fashions.

The laparoscopic hernia repair, in which a laparoscope (a tiny telescope) connected to a special camera is inserted through a cannula, a small hollow tube, allowing the surgeon to view the hernia and surrounding tissue on a video screen.

Other cannulas are inserted which allow your surgeon to work “inside.” Usually three small incisions 5-10mm is all that is required to do the surgery.

The hernia is repaired from behind the abdominal wall. A small piece of surgical mesh is placed over the hernia defect and held in place with small surgical staples. This operation is usually performed with general anesthesia.

What happens if the operation cannot be performed or completed by the laparoscopic method?

In a small number of patients the laparoscopic method cannot be performed. Factors that may increase the possibility of choosing or converting to the “open” procedure may include obesity, a history of prior abdominal surgery causing dense scar tissue, inability to visualize organs or bleeding problems during the operation.

The decision to perform the open procedure is a judgment decision made by your doctor either before or during the actual operation. When the surgeon feels that it is safest to convert from the laparoscopic procedure to an open one, this is not a complication, but rather sound surgical judgment.

The decision to convert to an open procedure is strictly based on patient safety.

What should I expect after surgery?

Following the operation, you will be transferred to the recovery room where you will be monitored for one to two hours until you are fully awake.

Once you are awake and able to walk, you will be sent home.

With any hernia operation, you can expect some soreness mostly during the first 24 to 48 hours. You are encouraged to be up and about the day after surgery.

With laparoscopic hernia repair, you will probably be able to get back to your normal activities within a short amount of time.

These activities include showering, driving, walking up stairs, lifting, working and engaging in sexual intercourse.

Mr Ahmad has a large hernia practice. He has performed over 2,000 hernia operation using different techniques. He specialises in open technique using minimally invasive method of plug repair. He practice both in surgical Probus centre and Duchy hospital, Truro, Cornwall.

 

To arrange a free consultation please either ring Probus surgical centre on 01726-885104 or his private secretary on 07478488814

 

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