erupt when a weakened abdominal
muscle tears open, permitting the
organs inside to push through. Typically,
a hernia will pouch out, looking
like a balloon beneath the skin.
Two areas are especially vulnerable.
YOU SHOULD KNOW
Inguinal (IN-gwih-null) hernias appear at
the point where the leg joins the abdomen.
Men feel this type of hernia as a lump in
the scrotum. Umbilical (um-BILL-ih-kull)
hernias crop up at the navel. Surgical scars
present yet another opportunity for hernias---in
this case called incisional hernias. A hernia
repair is known medically as a herniorrhaphy
(HER-nee-OR-uh-fee). Two techniques are
in use today:
Open Herniorrhaphy: In this approach,
the doctor makes a single long incision
over the hernia, removes the protruding
sac if necessary, and sews the torn muscle
closed. Man-made mesh may be applied to
the inside of the muscle wall to further
strengthen it. The operation typically
takes between 1 and 2 hours.
Laparoscopic Herniorrhaphy: This version
of the procedure is accomplished through
two small incisions, one in the abdomen,
the other close to the hernia. With the
aid of a tiny lighted scope, the surgeon
uses miniature, remote-controlled surgical
instruments to make the repair from within
the abdomen. Like an open herniorrhaphy,
the procedure lasts 1 to 2 hours.
There are always risks with surgery. You
might develop internal bleeding or get an
infection. Blood clots could form and lodge
in the lungs, making it difficult to breath.
However, if the hernia isn't repaired, there's
a chance that a portion of the intestine
will get stuck in it. Starved of adequate
circulation, this tissue could eventually
die, leading to a life-threatening case
YOU'RE HEADING FOR THE HOSPITAL...
Week Before Surgery:
You'll probably need to stop taking aspirin
and ibuprofen; the doctor will tell you
when. If you're taking aspirin for your
heart, don't stop without asking the doctor
first. Also ask whether you can take any
Your doctor will tell you whether you
need to have blood drawn.
The Night Before Surgery:
Your physician may suggest you take
a sleeping pill.
Just before surgery, you should not
eat or drink anything (even water).
Your doctor will tell you when to begin
Check with your doctor before taking
insulin, diabetes pills, blood pressure
medicine, heart pills, or any other
medication on the day of surgery.
Do not wear contact lenses to the hospital.
You may wear glasses.
to Expect While You're There
- You may encounter
the following procedures and equipment
during your stay.
- Taking Vital
Signs: These include your temperature,
blood pressure, pulse (counting your
heartbeats), and respirations (counting
your breaths). A stethoscope is used
to listen to your heart and lungs. Your
blood pressure is taken by wrapping
a cuff around your arm.
- Blood Tests:
You may need blood taken for tests.
It can be drawn from a vein in your
hand or from the bend in your elbow.
Several samples may be needed.
- Chest X-ray:
The doctor will check this picture of
your lungs and heart to make sure you're
ready for surgery.
- Heart Monitor:
(Also called an electrocardiogram [e-LEK-tro-KAR-di-o-gram]
or EKG). Typically, three to five sticky
pads are placed on different parts of
your body. Each pad has a wire that
is hooked to a TV-type screen or to
a small portable box (telemetry unit)
that shows a tracing of each heartbeat.
- IV: A tube
placed in your vein for giving medicine
or liquids. It will be capped or have
tubing connected to it.
- Pulse Oximeter:
With a little clip connected to your
ear, finger, or toe, this machine measures
the oxygen in your blood.
You'll need a pain-killer during the
operation. For this type of surgery,
the following options are available:
- Spinal Anesthesia:
This type of anesthesia requires an
injection in the spine. You will be
awake during surgery but will be numb
below the waist. Feeling will return
in about 2 hours.
- Epidural Anesthesia:
For this type, a tiny tube is positioned
near the spine, allowing administration
of additional medication during the
operation. You will be awake during
surgery but will be numb below the waist.
Feeling will return to your legs when
the anesthesia wears off.
- General Anesthesia:
This alternative puts you completely
to sleep throughout the operation. The
anesthetic is given either as a liquid
in your IV or as a gas through a face
mask or endotracheal (END-o-TRA-kee-ull)
tube placed in your mouth and throat.
The incision will be bandaged to keep the
area clean and prevent infection. (A nurse
may briefly remove the bandage and check
the stitches shortly after surgery.) You'll
need to stay in bed until the doctor says
it's safe to get up. As you begin your recovery,
you can expect the following:
Oxygen: At times during your stay, your
body may need extra oxygen. It is given
either through a plastic mask over your
mouth and nose or through nasal prongs.
If the oxygen dries out your nose or
the nasal prongs bother you, tell your
nurse, but don't take off the oxygen
on your own.
Deep Breathing and Coughing: These exercises
help prevent a lung infection after
surgery. Deep breathing opens the tubes
going to your lungs. Coughing helps
to bring up sputum from your lungs and
keep them clear. You should deep breathe
and cough every hour while you are awake,
including any time you spend awake during
Hold a pillow tightly against your abdomen
to help reduce pain from your incision.
Take a deep breath and hold it as long
as you can. Then push the air out of
your lungs with a deep strong cough.
Put any sputum that you have coughed
up into a tissue. Take 10 deep breaths
in a row every hour while awake. Remember
to follow each deep breath with a cough.
Incentive spirometer (spy-ROM-uh-tur):
This piece of equipment helps you take
deeper breaths. Put the plastic nozzle
into your mouth, take a very deep breath,
and hold it as long as possible. Then
blow as hard as you can into the mouthpiece.
Take 10 deep breaths in a row every
hour while awake. Remember to follow
each deep breath with a cough.
Drains: Thin rubber tubes may be put
into the area around your incision to
drain off excess fluid. They will be
taken out when no longer needed.
Swelling: After an inguinal hernia repair,
men tend to develop a red and swollen
scrotum. Wearing a scrotal support (jock
strap) will help to relieve the discomfort.
An ice pack can also help. Put ice in
a plastic bag, cover it with a towel,
and place it over the area for 15 to
20 minutes out of every hour as long
as necessary. Do not sleep on the ice
After the first 24 to 48 hours, switch
to heat for pain or swelling. Use a
heating pad (turned on low) or a hot
water bottle, or sit in a warm water
bath for 15 to 20 minutes out of every
hour as long as needed. Do not sleep
on the heating pad or hot water bottle.
Heat brings blood to the area or the
surgery and helps it heal faster.
Activity: You may need to rest in bed
for a while. But even if you are confined
to bed, it's important exercise your
legs in order to stop blood clots from
forming. Lift one leg off the bed and
draw big circles with your toes, then
repeat with the other leg. You can also
try lying on your side and pretending
to pedal a bike. When you're told it's
OK to get out of bed, make sure someone
is with you the first time you try.
If you feel weak or dizzy, sit or lie
down right away.
These medicines help prevent bacterial
infection. They may be given by IV,
as a shot, or by mouth.
Pain Medicine: To ease pain after the
operation, your doctor will probably
prescribe medication to be given by
IV, as a shot, or by mouth. Tell the
doctor or your nurses if the pain won't
go away or keeps coming back.
Anti-Nausea Medicine: This medicine
calms your stomach and controls vomiting.
Your doctor may suggest you take it
at the same time as your pain medicine,
which sometimes upsets the stomach.
Stool Softeners: These medications make
bowel movements softer so you won't
need to strain.
take your medicine exactly as directed.
If it doesn't seem to help, let the
doctor know, but keep taking it until
told otherwise. If you've been prescribed
antibiotics, be sure to use them up,
even if you're feeling better. If a
medicine makes you drowsy, avoid driving
or using dangerous machinery.
When you are allowed to bathe or shower,
carefully wash the stitches or staples
with soap and water. Then put on a clean,
new bandage. Change your bandage any
time it gets wet or dirty.
Regular bowel movements can be difficult
after surgery. Don't strain if the stool
is too hard. Walking will help to stimulate
the bowels. Eating foods rich in fiber,
such as fruit, bran, cereal, and beans,
will also help restore regularity. Drink
plenty of liquids; prune juice may help
make the stool softer. Or, if your doctor
approves, you can take an over-the-counter
You'll need extra rest while you recuperate.
Try to gradually increase your activity
each day, resting whenever you feel
Avoid any heavy lifting until you get
the OK. If you have to lift heavy objects
at work, as the doctor for the best
way to go about it.
Your Doctor If...
Pain from the surgery won't go away or
You have trouble urinating.
Your incision is swollen and red, or you
see any pus. These are signs of infection.
Your stitches come apart.
Your bandage becomes soaked with blood.
You develop a high temperature.
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