A hernia occurs when an organ or tissue protrudes through the wall of the area in which it normally remains. Abdominal hernias are often caused by a defect at birth, an inherited weakness of the abdominal wall, aging or increased pressure in the abdominal cavity. Abdominal pressure may be the result of pregnancy, obesity, fluid collection, straining, lifting or severe coughing. Surgery is performed when the abdominal tissue or intestine must be placed back inside the abdominal cavity due to a cut-off blood supply or significant pain. Other conditions may also necessitate hernia surgery.
Surgery Types
Hernia surgery may be simple or complex, depending on the patient's medical condition. A simple surgery might involve a laparoscopic procedure in which the surgeon makes three or four small incisions while a complex surgery might involve making one large opening. In addition to placing the displaced abdominal contents where they belong, the surgeon may use mesh, wire or connective tissue to repair the defect in the abdominal wall. Hernia surgery may be elective or emergency and the patient may go home the same day or require several days of hospitalization.
Immediate Post-Operative Period
Many patients undergo general anesthesia for hernia repair. When the patient awakens, he may have an oxygen cannula in his nostrils, a device on his finger to measure his blood oxygen level, an intravenous line going into his arm or elsewhere, a nasogastric tube in his nose, a urinary catheter in his urethra and heart monitoring equipment. He can expect his blood pressure and temperature to be taken several times. His pain level will be assessed and he may have a drain protruding from the surgical area. He may have a large dressing or several small ones over the surgical site or sites. If the surgery involved the scrotal area, he may have cold packs applied to his scrotum to reduce painful swelling, explains "Medical-Surgical Nursing."
Home Convalescence
The patient is instructed to monitor his dressing and he may need to perform dressing changes several times each day, depending on the extent of the surgical wound. After a rest period, he will be allowed to resume most of his usual activities, although straining, lifting and coughing are discouraged for two to eight weeks after surgery. He may be encouraged to avoid constipation by eating a diet adequate in fiber and drinking plenty of fluids. A follow-up visit with the surgeon will be scheduled so that she can gauge the healing process and remove stitches, sutures or a drain if necessary.
Early Complications
Hernia surgery complications that may develop in the immediate postoperative period include allergy to the anesthesia, adverse reaction to the anesthesia, inability to urinate and uncontrolled bleeding. Some patients experience breathing difficulties or suffer a bad reaction to the pain medications administered.
Later Complications
Later complications include infection, recurrence of the hernia, poor wound healing and the return of bleeding. Patients are advised to report a fever, nausea, vomiting, unrelieved pain or unusual wound drainage. The Baylor College of Medicine explains that scarring is to be expected after the surgery.
References
- "Medical-Surgical Nursing"; Donna Ignatavicius, M.S., R.N. and Linda Workman, Ph.D., R.N.; 2002
- Baylor College of Medicine: Hernia Repair Abdominal
- Encylopedia of Surgery: Umbilical Hernia Repair
