Hernia Operation Afterward
CARE (before, during, and after) AT SIR JOHN MONASH PRIVATE HOSPITAL
We will describe the process, which takes place at this advanced day surgery facility.
The day before surgery you will be contacted by the staff of the hospital to confirm your time of arrival and admission, and to answer any specific questions.
You need to fast for four to six hours before the procedure – that is nothing to eat or drink from midnight, for morning cases – for afternoon cases a light breakfast is permissible.
You should take your medications normally on the day of the surgery – specific advice is given for diabetics. The medication can be taken with a small sip of water.
Sir John Monash Private Hospital is a pink building, situated on the left side of Clayton Road as you come from North Road. It is a pink building, which contains numerous other medical facilities. The operating theatre and hospital are upstairs.
It is just before the Monash Medical Centre – a very large public facility.
Once there, you will be admitted by a sister and then proceed to the change room and waiting facility. We try not to make you wait more than one hour.
Whilst in the holding area the Anaesthetist, Surgeon and Assistant will drop in to see you and check you out. When ready you will walk into the theatre with one of the sisters or anaesthetist.
Whilst you are lying down the Anaesthetist will give you an intravenous injection to make you sleepy and you will be shaved as necessary – please do not shave yourself, because it will increase the risk of infection.
Hernia Operation Afterward:
The surgery usually takes thirty to fifty minutes and this passes quickly and pleasantly – and painlessly.
You will then be wheeled to the recovery area where you will be for a short time. Your observations will be monitored. There is no pain because your local anaesthetic lasts four to eight hours.
You are asked to get dressed and then you sit in a recliner and after an hour or so you are usually ready to go home. The Surgeon will come to check you before you leave.
You need to be driven home and have someone in attendance at all times for the first night and early the next day
Complications following surgery are rare – there are several things to watch out for:
a) When you stand you may feel faint as a result of the procedure or the medications used. Therefore, always get up very slowly and have someone with you at all times when you stand up and when you are
walking about – even the next morning. There is a chance when you get up the next morning that you will be stiff and sore and may see stars or feel faint. Therefore only get up very slowly and see how you go. Have somebody in attendance – in other words be careful. When you go to the toilet or shower you should let someone know. You may require painkillers of varying strengths. Some patients react adversely to painkillers. Painkillers should be adjusted as necessary.
The main types of painkillers used are tablets such as Panadol, Panadeine, Panadeine Forte, Digesic and also the anti-inflammatory medication such as Neurofen. You will be given instructions regarding their use.
Painkillers can also make you constipated and give you abdominal distension and feel very uncomfortable. This can be treated with a suppository or a small enema from the Chemist, such as a Microlax enema.
Injections for pain are rarely needed as are medications for nausea or vomiting. Nausea and vomiting following this procedure under L/A with sedation are rare, but if they do occur it can be due to the medication or the procedure itself.
b) The Dressing:
You will have a waterproof dressing in place. This can be left intact until you are reviewed the following week. You may shower directly onto the dressing, but do not rub too hard. You may notice some blood under the dressing but this is of no concern unless there is actual blood escaping from underneath the dressing onto your bare skin – i.e. actually dripping. If this is the case you should lie down and press on it and let someone know.
If the dressing comes off or it is very moist, it can be replaced. If there are any concerns, the Surgeon should be contacted.
The recovery of every patient following this type of procedure is different – sometimes for exactly the same procedure the range of recovery is amazing and is one of those things we really cannot explain.
There are some patients who do not take any painkillers and have very little pain and get back to normal mobility within one or two days. Whilst, there are others, who need painkillers for three or four days – not all the time. There are others that take longer to get back to normal.
We encourage you to be as mobile as possible and take painkillers if you feel they are necessary.
The wound itself may become swollen and there can be some bruising in the scrotal area in males. This is not a great cause for alarm. It is due to some blood tracking down with gravity from the wound site.
Complications following the surgery are uncommon but if you do feel that you have a complication you should let us know.
The wound may be quite thickened for a week or so, and in fact there is often a ridge palpable for two or three months. This always returns to normal.
Possible complications with the wound are infection or severe bleeding. These are both rare as audit of our results have shown. However, if you have some concern then you should be in contact and will be reviewed.
The technique with L/A under Neurolept sedation makes for less post-operative complications. For example there are less:
Respiratory problems – very important in the elderly, smokers and people with obstructive airway disease.
Many patients these days have had heart conditions such as an irregular pulse and have had stents or bypasses. Cardiac problems after the surgery however are extremely uncommon.
Under local anaesthetic technique urinary problems – such as retention of the urine where you cannot urinate and get a full painful bladder is rare.
As mentioned elsewhere clots in the leg are also rare using this technique.
MOBILISATION FOLLOWING SURGERY:
You are encouraged to mobilise and be as active as possible. We are against driving for about one week, because if you were to suddenly break, you may be inhibited by some discomfort in the wound or this may cause you pain. We do not encourage any heavy lifting for some four to six weeks. The repair is strong almost from day one but we believe in being sensible. It is hard to give you actual weight measurements, which you cannot lift. However a general rule would be that you should not lift anything, which is uncomfortable.
Of course, we suggest that when you do cough, sneeze, laugh or strain you place your hand over the wound for some support.
We feel we have dealt with most of the common issues following surgery. One matter, which sometimes comes up, is sensitivity to the dressings or even an allergy. You should of course let us know about this prior to the procedure, but if there is excessive itchiness or some unusual feature then the dressing can be removed and we can be notified. Occasionally in men the moisture following surgery causes exacerbation of any fungal problems etc.
SUMMARY:
Sir John Monash Private Hospital is a day surgery facility although it does have an overnight licence. We have found that over the years that it is rare for anybody to need readmission after their discharge home. We have had for example, a patient who has developed an attack of gallstones, or another patient who developed an irregular pulse. Should there be any significant problem you should of course notify us immediately. As part of the service Sir John Monash Private will ring you a day or two following surgery to check how you are going and ask you a series of questions.
You will be reviewed routinely during the week following the surgery or earlier if you need.
We hope you find this information of use and if you have other further suggestions about post-operative care, which should be mentioned, please let us know.