Overview
Herniotomy is an abdominal surgery involving the surgical repair of a hernia. The most common types of hernia are inguinal (near the groin), umbilical (near the navel), and femoral (above the inner thigh). Hernias occur when an internal organ pushes through your muscle or tissue wall.
Hernia repair surgery includes herniotomy, herniorrhaphy, and hernioplasty. The latter two deal with the inguinal canal's posterior wall repair and replacement, while herniotomy deals only with the hernial sac removal.
Alternate Name of Herniotomy
Hernia surgery or hernial sac removal surgery.
Body location
Abdominal cavity (near the groin).
Preparation for Herniotomy Surgery
Here is a quick guide to help you prepare for this procedure:
- Diet: This procedure requires you to be on an empty stomach. Avoid consuming food or drink the night before or at least eight hours before the surgery.
- Pre-operative tests: Your surgeon will ask you to undertake an ultrasound before the procedure. You will also have to get other standard tests like blood work, chest X-ray, blood pressure measurements, and ECG.
- Medications: Please discuss past medical conditions with your healthcare provider and inform them about any regular medicines you take, such as blood thinners, anti-inflammatory drugs, or even supplements. You may need to stop consuming them a while before the surgery.
- Written consent: Before signing the consent form, ensure you enquire about the benefits and risks associated with the procedure.
- Other arrangements: Arrange for your family member or friend to drive you home after the procedure.
How is Herniotomy Surgery Performed?
Your doctor may perform the herniotomy procedure in two ways.
- Open herniotomy: The surgeon will first administer general anaesthesia since it is an open surgery. Depending on the circumstances, they make an incision through which the hernia is pushed back into place, tied off, or removed. Then, the surgeon will stitch the muscle wall (dissolvable stitches) through which the hernia protrusion took place. If the hernia size is large, the surgeon may fix a flexible mesh to support the area and prevent the hernia from pushing through again.
- Laparoscopic herniotomy: The surgeon injects gas into your abdomen to distend it and increase the visibility of your internal organs. They make a small cut to get access to the hernia site. Then, they insert a tube with a camera fitted at the end (laparoscope) to generate images. These laparoscopic images act as a visual guide and enable the surgeon to complete the hernia removal process and repair the area with a mesh.
Follow up After Herniotomy Surgery
Herniotomy is usually a part of an outpatient procedure. In complex hernia cases, you may need to stay for one to three days in the hospital or clinic after the procedure. You can remove the bandages at the incision site 24 hours after the surgery. The doctor may advise you to use a pillow over the surgical area to apply pressure when you cough or sneeze. To reduce swelling around the incision, use an ice pack and wear comfortable and loose innerwear. Start with soft foods and liquids before transitioning to your regular diet. The clinic will schedule a follow-up appointment in two weeks to check your progress.
Follow your healthcare provider's suggestions about the diet, the activities you can resume, and how to care for the wound at the incision site. The doctor may prescribe pain medications for a few days to help you deal with post-surgery pain and discomfort.
Your doctor or surgeon will encourage you to start with your movements soon after the surgery, as it improves circulation, prevents blood clots and constipation, and promotes faster healing. Please call your healthcare provider immediately if you notice bleeding, abnormal swelling and redness at the incision site, inability to urinate even after 12 hours, shortness of breath, and body temperatures over 100.5 degrees Fahrenheit.
Recovery After Herniotomy Surgery
Laparoscopic herniotomy is relatively safer than open herniotomy. It has the advantages of better tolerance and results, less postoperative pain and complications, and faster recovery. Most people resume normal functioning within two or three weeks after the surgery. Full recovery takes around three to six weeks. Avoid strenuous physical exercise and activities for at least a month (or as advised) post the procedure.
Irrespective of hernia surgery, recurrence of hernias is common. Inherent tissue weakness, smoking, and obesity increase the risks of hernia recurrence. According to the International Guidelines for Groin Hernia Management, about 10% of inguinal hernia patients experience chronic pain even after the surgery (for three months or longer), which requires conservative management.
Risks Associated with Herniotomy Surgery
Although herniotomy is a relatively routine and safe procedure, there may be possible complications and side effects associated with it, as discussed below:
- Swelling: Fluid accumulation and swelling of genital areas after a herniotomy are frequent and should subside in a few days.
- Infection: Although it is a clean procedure, there may be rare cases of infection. Get it checked because infections may also be a sign of recurrence.
- Postoperative haemorrhaging: Hematomas (localised bleeding around the wound) may occur but usually resolve in a week.
- Pain: Injury to your muscles, skin, or nerves during the procedure may cause a painful sensation in the operated region.
- Blood clots: Clots that may lead to pulmonary embolism are among the most dangerous (though rare) complications post herniotomy.