Repair of Incisional Hernia Operation Patient Information Day Surgery Ward 2 & 3, Leigh Infirmary Author ID: LS Leaflet Number: SW3.012 Name of Leaflet: Repair of Incisional Hernia Operation Date Produced: January 2013 Review Date: January 2015 Repair of Incisional Hernia Operation Page 1 of 9
Welcome to: Day Surgery Ward 2 & 3 Leigh Infirmary, The Avenue Leigh, WN7 1HS Ward 2, 7:30am to 5:30pm, Monday to Friday, Telephone 01942 264256 Ward 3, 7:30am to 9:00pm, Monday to Thursday, Telephone 01942 264260 or 264261 This leaflet aims to give you information about your operation and your stay in hospital and advice for when you go home. If there is anything you are worried about that is not covered in this leaflet, please feel free to speak to a member of staff. What is an Incisional Hernia? An incisional hernia occurs due to a weakness, separation, gap or opening in the muscles or supporting structures of the abdominal wall directly at, or in the region of a previous surgical incision. This may cause a bulge and/or pain and discomfort. Surgery involves repair of the area of the weakness and return of the abdominal contents back into their normal position. Mesh repairs are where a piece of mesh is placed over the repaired hernia to give it added strength. Patients with a large incisional hernia have a procedure known as stoppa repair, this involves placing one, sometimes two pieces of mesh to reinforce the defect. What are the benefits of having an operation to repair my hernia? Having the hernia repaired can stop it from becoming any bigger. The bigger it becomes the more likely you are to develop complications. The most serious complication is known as strangulation, where part of the intestine becomes trapped within the hernia. This can cause severe pain and vomiting. If you have any of these symptoms you should go to your local accident and emergency department as soon as possible. Are there any risks involved in having an operation to repair a hernia? Surgical risks include, recurrence of the hernia, scarring, infection, bleeding, collection of blood (haematoma), bruising, numbness or chronic incisional pain. These will be explained to you when you sign your consent form. If you have any worries about anything regarding this please ask to speak to your consultant. Alternatives If surgery isn t an option as you are high risk or asymptomatic, you may be managed with or without an abdominal binder (pressure belt). Repair of Incisional Hernia Operation Page 2 of 9
Pre-Operative Assessment Clinic At the clinic you will be seen by a nurse, who will complete a pre-operative screening assessment. This will include taking a nursing and anaesthetic history, organising investigations such as blood tests, ECG s; as necessary. The nurse will advise you about your particular operation. He/she will explain to you about your pre and post operative care, how long you will need someone to take care of you when you go home and how long you will be expected to be off work, etc. If you need a sick note please ask the nurse on arrival to hospital. How long will I be in hospital? Ward 2 & 3 are day surgery wards with no overnight facilities. Your operation has been planned as a day case procedure which means that you will be able to come into hospital and be discharged later the same day. Very rarely, some patients do not recover in time to go home and will therefore need to be transferred to the Royal Albert Edward Infirmary, Wigan. What sort of anaesthetic will I have? Incisional hernia operations are carried out under a general anaesthetic, which means you will be fully asleep. Before you come into hospital Please have a bath or shower. Please do not shave the operation site, as this will be done on admission prior to theatre. Admission to hospital On arrival to hospital, you will need to book in at the admissions desk situated on the ground floor below Wards 2 and 3. You will then be directed to the ward; here you will meet your nurse and other members of the team who are looking after you. The facilities and general routine of the ward will be explained to you. Getting ready for the operation You will be asked to put on a theatre gown. Prior to theatre your surgeon will see you, you will be asked to sign a consent form if you have not already done so to say that you understand what you have come into hospital for and what the operation involves. If you have any questions, please ask. You will also be seen by your anaesthetist; this is the doctor who will give you your anaesthetic and look after you whilst you are asleep. (Please note that you will be on a theatre list with several other patients, so be prepared for a wait). Repair of Incisional Hernia Operation Page 3 of 9
After your operation You will wake up in the recovery room; here specially trained nurses will monitor closely how you feel. On waking you will have a small clear oxygen mask in place, this will help the anaesthetic wear off. The nurses will check your blood pressure and pulse and make sure that you are comfortable. When the doctors and nurses are happy with your condition you will be taken back to the ward where you will be made comfortable and can rest. Refreshments will be offered as soon as it is safe for you to have these. Pain control Expect some discomfort/pain. You will be given strong pain killing and/or local anaesthetic drugs in theatre, which will reduce pain for the first few hours. Your pain will be closely monitored to ensure that it is kept to a minimum. You will be offered and given pain relief, as appropriate. On discharge you will be provided with pain-killing tablets, which you should take as prescribed for the first two days and as needed thereafter, but do not exceed the stated dose. If you have to cough, support the wound by pressing on it with the flat of your hand. The wound It is essential that your wound remains clean and dry during the healing period. Your wound dressing should not be disturbed for a minimum of 48 hours. It is advised that if all is well you keep your dressing in place until your clips or stitches are removed. If you have dissolving stitches you should be able to remove the dressing after 7 days and treat the wound as normal. The dressing is shower proof, please avoid soaking in the bath until the wound is fully healed, as this may delay normal healing. If the wound does become wet, remove your dressing and pat the wound dry gently with a clean towel and redress the wound. If the dressing needs to be changed, make sure that you wash your hands and avoid touching the wound. The district nurse will remove your stitches/clips in 7 to 10 days after your operation. If dissolving stitches have been used, these do not need to be removed. The ward will provide you with a district nurse referral form and contact numbers so that you can arrange for a wound check if you have any concerns and for removal of your stitches/clips. Going home You must make sure that an adult can take you home in a car or taxi. You will need to go home and rest. An adult must stay with you for the first 24 hours after your operation. Avoid alcohol for a minimum of 48 hours after surgery and whilst taking painkillers. What to look out for It may be several hours before you pass water. If you have difficulty, particularly if your bladder feels uncomfortably full but you still cannot pass water, you should attend your local Accident and Emergency department. Repair of Incisional Hernia Operation Page 4 of 9
You should not experience severe pain, nausea and vomiting, excessive bruising or persistent bleeding. If you do, please seek medical advice by contacting your G.P., or your local Accident & Emergency department, Royal Albert Edward Infirmary Telephone 01942 244000. You may also ring for advice by contacting one of the numbers below: Ward 2-01942 264256 Ward 3 01942 264260 or 264261 After hours district nursing service, available between 7:00pm 7:30 am Mobile 07860794654 or answer phone 01942 481155 It is important to avoid constipation and straining after your operation, your bowels may be affected by your painkillers. To help prevent this drink plenty of fluids, water is especially good for you. Take plenty of fibre in your diet. If you are having difficulty, use a mild laxative, e.g. Senokot or seek advice from your G.P. If the wound is showing signs of infection, i.e. increased pain, redness, swelling or discharge or you have a high temperature, seek advice from your G.P. The first few days Gently increase your activity over the first few days, little and often until you can do more each day. You are encouraged to move and walk as this will help prevent stiffness, soreness and help with your circulation and minimize the risk of complications such as chest infection, deep vein blood clots and clots to the lungs. Take painkillers to ease any discomfort to enable you to mobilize. Work and activity You can get a sick note from the ward for the first two weeks. You will need to see your GP for any further sick notes. How quickly you get back to work depends on the type of job you have. Two to four weeks is usual. Mesh repairs allow you to carry out all normal activities two weeks after surgery without risk of harming yourself. No heavy lifting for six weeks. You may resume sexual relations as soon as it feels comfortable to do so. Repair of Incisional Hernia Operation Page 5 of 9
Driving We advise that you do not resume driving until your wound has healed and you are confident that you can do an emergency stop. Two to four weeks is usual. We also advise that you check with your insurance company, as policies sometimes carry restrictions and these may vary. Outpatients Not all patients are given a routine follow-up appointment. This will depend on which consultant you had your operation with. If you are not provided with an appointment and encounter any problems that you feel you need to see your surgeon about, please contact your G.P. or consultant s secretary for advice. Repair of Incisional Hernia Operation Page 6 of 9
Research Research is undertaken to add to the existing scientific knowledge on a particular subject. There are a number of staff within the Trust who conduct Research studies. It is possible that during the course of your treatment you may be asked to take part in a research study, however, you do have the right to refuse, and this will not affect the care that you receive. Your NHS Number, Keep it Safe Every person registered with the NHS in England and Wales has their own unique NHS Number. It is made up of 10 digits for example 123 456 7890. Everyone needs to use the NHS Number to identify you correctly. It is an important step towards improving the safety of your healthcare. Always bring your NHS number with you to all hospital appointments or quote it if you need to telephone the hospital for any enquires. This will allow staff to check that they have the right patient details by checking this against your NHS number. To improve safety always check your NHS Number on correspondence the NHS sends to you. Ways of finding out your NHS Number If you do not know your NHS number, contact your GP or local Primary Care Trust. You may be asked for proof of your identity, for example a passport or other form of identity this is to protect your privacy. Once you have obtained your NHS Number write it down and Keep it Safe. My NHS Number Information Rights and Access The Trust will keep your information secure and confidential at all times. The Data Protection Act 1998 states that personal and sensitive information must be processed fairly, lawfully and securely. This applies to all information we hold whether on paper or electronically on computer systems. All personal information is processed fairly, lawfully and as transparently as possible so that you: Understand the reasons for us processing your personal information Give your consent for the disclosure and use of information where necessary Gain trust in the way we handle your information Know that you have the right to request access to personal information we hold about you Information relating to the business of the Trust is available under the Freedom of Information Act 2000. For example, what we spend and what we do. You can find out more by visiting the Trust website or submitting a Freedom of Information request to the Trust for this information. For further information regarding data protection, please read our leaflet called How we use your personal information. For Freedom of Information, please read our leaflet called The Freedom of Information Act and You. You can also visit the Information Governance pages on the Trust website. Repair of Incisional Hernia Operation Page 7 of 9
Patient Relations The Patient Relations/PALS Department provides confidential on the spot advice, information and support to patients, relatives, friends and carers. We will do our best to help you to resolve any concerns you may have about the care you received. We can also give you information on the services provided by the Trust. If you have a concern or there is a problem, the best way to get it resolved is usually to tell someone there and then. If you are on a ward, talk to the sister or charge nurse on duty, in a clinic, talk to the receptionist or one of the nursing staff. If you want to talk to a senior manager or to someone who has not been directly involved in your care and treatment, we can usually arrange this during office hours. You can also ask to speak to a member of the Patient Relations/PALS Department. Staff in any ward or department will be able to contact a member of the team for you, or you can telephone 01942 822376. The Patient Relations/PALS Department is open Monday to Friday, 9am to 4pm. Outside of these hours there is an answer-phone service. In addition to Patient Relations/PALS Service you can contact CARE LINE. This is available from 9am to 9pm Monday to Friday excluding Bank Holidays, and 9am to 5pm at weekends. Please telephone CARE LINE on 01942 773377 and follow the instructions given. If you wish to make a formal complaint you can telephone or write to: The Patient Relations/PALS Manager Wrightington, Wigan and Leigh NHS Foundation Trust Royal Albert Edward Infirmary Wigan Lane Wigan WN1 2NN Telephone: 01942 822376 Your views of the service that we provide are important. You can also let us know how you feel by posting your comments on the Patient Opinion website. You can access this from the Trust website on www.wwl.nhs.uk or via www.patientopinion.org.uk Social Media Along with keeping patients, visitors and staff up to date with news and events on our internet site, the Trust also has Facebook and Twitter pages. Facebook: www.facebook.com/wwlnhs Twitter: www.twitter.com/wwlnhs Wrightington, Wigan and Leigh Health Services Charity Wrightington, Wigan and Leigh Health Services Charity (Registered Charity Number 1048659) aims to further improve the quality of the patient experience and care. The Charity relies on the generosity and support of the local community. If you feel you can help or would like more information please visit our website at www.wwl.nhs.uk/charity or contact our Fundraising Officer via elizabeth.titley@wwl.nhs.uk. Repair of Incisional Hernia Operation Page 8 of 9
Membership As a Foundation Trust we are keen to build a successful and engaging membership group. As a member of your local hospital you will be kept up to date with news, service developments and future improvements. Why become a Member? Membership provides local people, patients and service users with an opportunity to have a greater say in how we deliver our services. For further information please call freephone 0800 073 1477. Who can become a Member? Anyone can become a member you just need to be 16 years of age or over and live in the UK. As a member it will be up to you how much you want to get involved. How to become a Member? To apply to become a Member: Telephone freephone 0800 073 1477 Email foundationtrust@wwl.nhs.uk Visit www.wwl.nhs.uk Stop Smoking Support A visit to hospital is very often the trigger for many people to quit smoking, and we know that 70% of people that smoke would like to quit. The Trust is a smoke free area and smoking is prohibited in all buildings, grounds and car parks. For patients wishing to quit smoking following their admission to hospital, or if patients simply require support during their hospital stay, there is a designated specialist Stop Smoking Team available. Patients that aren t staying in hospital or are planning to quit ahead of their hospital stay can also access specialist support. The Wigan Stop Smoking Service community team provides support across the borough. You can call us on 01942 482539 or free on 0500 7867 669 to speak to a member of the team or visit www.alwch.nhs.uk/stopsmoking for further information. This leaflet is also available in audio, large print, Braille and other languages upon request. For more information call 01942 773106. Wrightington, Wigan and Leigh NHS Foundation Trust All rights reserved. Not to be reproduced in whole or in part without the permission of the copyright owner Repair of Incisional Hernia Operation Page 9 of 9