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Getting Ready for Surgery
Once the decision has been made to have hernia surgery at Bon Secours Hernia Center at Mary Immaculate l, you can rest assured that the staff is ready to help you every step of the way. Our dedicated teams of professional are here to assist you with regaining an active lifestyle.
Prior to Surgery | Day of Surgery | Going Home
Prior to surgery
In the days prior to your hernia surgery, your will receive a phone call from our pre-anesthesia nursing staff to answer your questions and schedule pre-anesthesia testing and teaching (PAT).
During this important visit with the PAT nurse, you may be required to have blood tests, a urinalysis, and other studies required for surgery. Please bring the following items with you to your pre-anesthesia testing visit:
- written list of all current medications, including over-the counter drugs, vitamins, herbal preparations and supplements, along with the dosage and time of day you take each of these items
- written list of all allergies
- medical insurance card
- consent form or notes from your doctor listing the test you need.
Your doctor may direct you to:
- Stop all medications, even over-the-counter medications such as aspirin and Tylenol®
- Stop smoking, to avoid straining your hernia by coughing and to promote good blood flow for healing after surgery
- Avoid heavy lifting, which may irritate your hernia
Unless your surgeon states otherwise, Do Not eat or drink anything after midnight—including water and chewing gum. Eating and drinking prior to surgery can result in your surgery being cancelled.
Do Not Smoke
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THE BIG DAY
Leaving for the Hospital
- You may shower
- Brush your teeth. You may brush your teeth and rinse with water, but do not swallow the water
- Take medication. Take only the medications as instructed by your pre-anesthesia testing nurse or doctor with a sip of water (approximately 1 teaspoon).
- Wear loose fitting clothing
- Leave valuables at home
Reporting to the Hospital
- Check in at the main lobby of the Surgical Pavilion.
- The nursing staff will assist you to a private room
- Sign and complete any additional paper work
- Change into a hospital surgical attire
- Have a brief physical examination by the nursing team
- Receive an IV tube and fluids
- The incision site may need to be shaved
Holding Area
After you have completed the preliminary preparations for surgery you will be transported to the second floor of the Surgical Pavilion. In this area you will meet your Anesthesia and Operating Room Team. You will also get a chance to see your Surgeon prior to going into the Operating Room.
Going Into Surgery
For the most common Inguinal Hernia, we utilize a "Tension Free" repair, increasingly recognized by Hernia Specialists as the most superior method for hernia surgery. We are now convinced that this technique is truly the "State of the Art" in hernia surgery, providing the safest, most effective repair with the least post-operative pain. This method is the only safe, surgical hernia repair method that completely addresses and reinforces the hernia-prone region called the Myopectineal Orifice of the groin. Complete, Tension-Free mesh reinfocement of the Myopectineal Orifice provided by this method is now fully recognized by Hernia Specialists world-wide as the critically most important feature of an effective, primary inguinal hernia repair and in preventing recurrences later on.
We utilize a Mini-Incision "Open" Technique, using the full spectrum of anesthesia. Each anesthetic is tailored for the safety and comfort of our patients by our Board Certified Anesthesiologists and state certified Nurse Anesththetists.
Surgery is performed through a small incision (about 2 inches in most average patients). With the patient awake, yet calm and sedated, comfortably free of pain, the risks of General Anesthesia are avoided. Our patients are walking shortly after surgery, and are discharged home within about 1-2 hours.
Once the hernia (bulge) is freed up by gentle dissection, it is returned through the hole or weakness into its proper position. Rather than just covering the weakness at this point, a specially designed, sterile "Mesh" system is gently placed through the defect. It opens to cover and effectively repair the defect from the inside, the best place for mesh to be positioned. This mesh extends well beyond the under edges of the defect to reduce pressure on the hernia defect opening, and reinforce the entire hernia-prone area (called the Myopectineal Orifice) at the same time. The mesh is held in place without tension. No painfully tight sutures are placed to pull muscle unnaturally together, nor are staples or tacks utilized in this method. By utilizing mesh to reinforce the defect, sutureline tension that is seen in previously standard tissue-to-tissue repairs is eliminated with this technique, while fully preserving both the normal anatomic structure and physiologic functions of the inguinal area.
After this "underlay" mesh is properly positioned, an additional sheet of mesh is included over the defect as an insurance reinforcement to the entire area. This is placed in a completely tension free fashion, being held in place by a "VELCRO-Like" effect of the mesh itself. Since there is no tension and only a minimal amount of surgical dissection, there is little post operative pain, and patients return to NORMAL ACTIVITY in DAYS. This technique has been essentially utilized for over 10 years, with recurrence rates of Less than 1/2 %, lower than any other technique including the conventional suture repairs, (TENSION REPAIR), or the Laparoscopic "Keyhole"Approach. WE FIRMLY BELIEVE THE TENSION FREE APPROACH IS THE MOST EFFECTIVE METHOD AVAILABLE.
Several Mesh Systems" are available. We feel that no two patients are alike and therefore no two hernias are alike either. All hernias differ from patient to patient, often quite significantly. We therefore feel that no one single TENSION FREE operative approach nor single mesh product system is suitable for all patients or all hernias.
Surgery at the Bon Secours Hernia Center at Mary Immaculate is tailored specifically to the individual needs of each and every patient. We are expertly familiar with the various advanced Tension Free repair techniques commonly in use today, and all of these mesh system methods and diverse products are fully available to us. Rather than utilizing the same mesh product for all hernias, we individually select the precise mesh product (selecting the precise size, shape, configuration and manufacturer) at the time of surgery that is best suited for each hernia. This selection process, which is the foundation for what we call the "Benchmark" approach, is based on our extensive experience, developed by performing nearly one thousand various hernia repairs annually and "specializing" in hernia repairs for over 20 years. This expertise in both routine and complex hernia surgery assures that all of our patients receive the most satisfactory, safest and importantly the most effective repair available.
Recovery is therefore more rapid! Pain is minimal, since muscles not cut and are neither pulled together nor sewn under tension. Post-operative restrictions are few, if any, and our patients can actually return to NORMAL activity in DAYS! This includes resumption of work and recreational activity when desired.
This fully effective contemporary repair technique allows for your comfortably rapid recovery. The advanced techniques we utilize are associated with the Lowest Risk of Recurrence when compared to most other older surgical techniques which place extreme tension on the muscle and the repair by simply cutting and sewing muscle together. Our BENCHMARK technique is equally safe and the fully effective for "Recurrent" Hernias as well.
In addition, and equally important, Hernia repair with this advanced "Benchmark" approach is:
- Safe and Fully Effective Surgical Repair
- Lowest Incidence of Recurrent Hernias in the Future (less than 1%)
- Minimal Post Operative Discomfort
- Few Restrictions on Activity
- RETURN TO NORMAL ACTIVITY IN DAYS
The Post-Anesthesia Care Unit
After your surgery is completed, you will be wheeled into the Post-Anesthesia Care Unit (PACU).
In the PACU:
- Nurses will frequently check your vitals signs (ie: blood pressure, pulse, breathing)
- Nurses will medicate you for pain as needed through your IV tube
- Nurses will check your bandages
- Usually recovery period is 1 hour
Phase II Unit
After your immediate recovery period in the PACU, you will be transported to the Phase II area.
In the Phase II prior to going home:
- Nurses will continue to check your vital signs
- Nurses will medicate you for pain as needed
- You’ll need to drink fluids
- You’ll need to urinate
- You’ll need to be able to walk with assistance.
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Discharged Home
Prior to going home:
- Your family will be given discharge instructions for care after surgery
- Follow-up appointment time
- Prescription written by surgeon
- Opportunity to answer and questions
Important Notes
- Arrange for someone to drive you home from the hospital or surgery center and remain with you for 24 hours
- It could take a day or two before you can get back to resume some of your normal activities.
- The first few days, you may notice some swelling or discoloration around the incision site, which is normal.
- It’s important to prevent constipation, which can put a strain on your incision. This is especially prudent if you are taking pain medications, as these can sometimes cause constipation. It is helpful to eat foods that are high in fiber and drink plenty of fluids, such as water and fruit juice.
When to Call Your Doctor
If you experience any of the following problems when you return home after surgery, call your doctor:
- Fever
- Excessive swelling
- Difficulty urinating
- Redness
- Bleeding
- Pain that gets worse
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