WHAT IS AN UMBILICAL HERNIA?

This is a weakness or swelling of the navel (belly button). It may become bigger, more uncomfortable or become unsightly. Sometimes fat or bowel gets stuck in the hernia causing severe pain and illness.

WHAT DOES THE OPERATION CONSIST OF?

A cut is made around the navel. Any fat or bowel that is inside the hernia is pushed back or removed. The weakness in the muscles is mended with strong stitches or a prosthetic sheet (mesh). The skin is then closed usually with dissolving stitches.

Umbilical Hernia - Open

RECEPTION

Please report to the hospital reception on time for your admission. Please bring along all the documents that be required such as your medical aid card, ID and contact details. If you are not a member of a medical aid you will be required to pay a deposit or to sign an indemnity form. As far as possible we will try to advise you about hospital costs before your admission. It may be best to complete some of the documentation beforehand at the hospital pre-admission clinic to save time on the day of your admission.

WELCOME TO THE WARD

You will be welcomed to the ward by the nurses or the receptionist and will have your details checked. Some basic tests will be done such as pulse, temperature, blood pressure and urine examination. You will be weighed and measured. You will be asked to hand in any medicines or drugs you may be taking, so that your drug treatment in hospital will be correct.

Please tell the nurses of any allergies to drugs or dressings. The surgeon will have explained the operation and you will be asked to sign your consent for the operation. If you are not clear about any part of the operation, then read this again and then ask for more details from the surgeon or from the nurses.

VISIT BY THE ANAESTHETIST

If you are having a general anaesthetic, the anaesthet ist who will be giving your anaesthetic will interview and examine you. He will be especially interested in chest troubles, dental treatment and any previous anaesthetics you have had.

DIET

You should not eat or drink anything for at least six hours before your operation and stop clear fluid two hours before unless you are prescribed specific nutritional supplements. However, you should take all your regular medication as usual on the day You will need to stop certain medication such as disprin, warfarin, or other blood thinning medicines (including homeopathic medication) well before the operation. Please discuss this with your surgeon.

SHAVING

The operation area will be shaved to remove excess hair. In theatre. Please do not shave or wax beforehand.

PREMEDICATION

You may be given a sedative by the anesthetist about one hour before the operation.

TRANSFER TO THEATRE

You will be taken on a trolley to the operating suite by the staff. You will be wearing a cotton gown and disposable underwear, rings will be fastened with tape and removable dentures and spectacles will be left on the ward. There will be several checks on your details on the way to the operating theatre where your anaesthetic will begin.

COMING ROUND AFTER THE ANAESTHETIC

Although you will be conscious a minute or two after the operation ends, you are unlikely to remember anything until you are back in your bed on the ward. Some patients feel a bit sick for up to 24 hours after operation, but this passes. You will be given some treatment for sickness if necessary.

WILL IT HURT?

There will be some discomfort on moving rather than severe pain. You will be given injections or tablets to control this as required. Ask for more if the pain is still unpleasant. You will be expected to get out of bed the day after operation despite the discomfort. You will not do the wound any harm, and the exercise is very helpful for you. The second day after operation you should be able to spend most of your time out of bed and in reasonable comfort. By the end of one week the wound should be virtually pain free.

DRINKING AND EATING

You will be able to drink within an hour or two of the operation provided you are not feeling sick. The next day you should be able to manage small helpings of normal food.

OPENING BOWELS

It is quite normal for the bowels not to open for a day or so after operation. A laxative is sometimes required.

THE WOUND

The wound has a dressing which may show some staining with blood in the first 24 hours. The wound is held together by dissolvable stitches. They are usually removed after seven-ten days. The dressing, is usually waterproof to allow showering.

Sometimes a plastic suction drain is used to suck out fluid from the wound. This will be attached to a plastic portable suction bottle. It is pain free and is removed after a day or two. There may be some purple bruising around the wound which spreads downward by gravity and fades to a yellow colour after two to three days. It is not important. There may be some swelling of the surrounding skin which also improves in two to three days.

After seven to ten days, slight crusts on the wound will fall off.

WASHING

You can wash the wound area as soon as the dressing has been removed. Soap and tap water are entirely adequate. Salted water is not necessary.

HOW LONG IN HOSPITAL?

Depending on the size of the hernia and your general health you may be able to leave hospital on the same day. Usually, however, you will feel fit enough to leave hospital after one or two days. Please contact your surgeons rooms to make a follow up appointment. Please ask your surgeon for any sick notes or certificates that you may require.

AFTER YOU LEAVE HOSPITAL

You are likely to feel a bit tired and need rests two or three times a day for a week or more. You will gradually improve so that after a month you will be able to return to your normal level of activity.

LIFTING

At first discomfort in the wound will prevent you from harming yourself by too heavy lifting. After one month you can lift whatever you like. There is no value in at tempting to speed the recovery of the wound by special exercises before the month is out.

DRIVING

You can drive as soon as you can make an emergency stop without discomfort in the wound, i.e. after about ten days.

WORK

You should be able to return to light work within two weeks and a heavy job within four weeks.

COMPLICATIONS

Complications are rare and seldom serious. If you think that all is not well, please ask the nurses or doctors.

Bruising and swelling may be troublesome, particularly if the hernia was large. The swelling may take four to six weeks to settle down. Infection is a rare problem and will be treated appropriately by the surgeon. Aches and twinges may be felt in the wound for up to six months. Occasion ally there are numb patches in the skin around the wound which get better after two to three months. The risk of a recurrence of the hernia is about 1 in 30.

GENERAL ADVICE

The operation should not be underestimated, but practically all patients are back at their normal activities within a month. If you have any problems or queries, please ask the nurses or doctors