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What is the post operative care after a hernia surgery?

Wednesday, 17 August 2005
Answered by: Dr. Prakash Khanduri
Gastro-Intestinal and Liver Transplant Surgeon,
St. Stephens Hospital & Pushpawati Singhania Research Institute,
New Delhi
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Q. I am a 48 years old female who has recently undergone surgery for strangulated incisional hernia with SAIO. I had developed sudden abdominal pain with vomiting so was admitted to the hospital and was managed conservatively for 2 days. Due to deteriorating condition, I was shifted to Apollo Hospital, where I underwent emergency exploratory laparotomy and hernia repair. I would like to know what is the period of rest required after the surgery? I had been given an abdominal binder after the operation from the hospital. It is very uncomfortable to wear it, especially to work in this season. I would like to know whether it is compulsory to wear it all the time even at office? Also, for how much time is the abdominal binder required to be worn and how does this help? I would like to know what are the precautions I should take in my daily routine life to prevent chances of recurrence? Also, as I did not have any symptoms or ailments pertaining to this problem earlier, how is it that I needed surgical intervention all of a sudden, starting with only abdominal pain? Please tell me in detail the cause as well as procedure adopted during the surgery to curtail the growth of hernia? What is ‘strangulated incisional hernia with SAIO’ and how does it occur? Are there any dietary restrictions too? Also, I would like to know whether there is some physical exercise required to be done after the operation, as my stomach has grown bigger in size after the surgery. I have already read all the available material on your website regarding this topic. I would like you to specifically get me answers to my queries from the concerned doctor on your panel after studying the details written above.

A.  Please find below the answers to your queries: 1. I think six to eight weeks of rest would be sufficient provided there are no complications. Please consult your surgeon regarding this. 2. There is no mention of the type of hernia repair performed and whether a mesh was used. Many surgeons do recommend an abdominal binder and three months should be sufficient period of time to wear it. The binder helps by providing support to the repaired abdominal muscles. By three months the tensile strength of the wound is approximately 95% complete and this is why the binder is recommended at least for three months. However, not all surgeons recommend its use and it is left to the discretion of the surgeon taking in to account various factors. If your surgeon had recommended its use you should wear it. 3. As regards precautions, there should not be excessive straining or lifting of heavy weight. A hernia occurs when there is a weakness or defect in the abdominal wall through which the abdominal contents (intestines) protrude out. In your case the previous incision was the point of weakness and that is why it is referred to as an Incisional Hernia. SAIO refers to sub-acute intestinal obstruction and a strangulated hernia means that the blood supply to the herniating intestine has been compromised. The operation involves reduction of the contents of the hernia and replacing them into the abdominal cavity and repairing the defect or weakness of the wall. 4. There are no dietary restrictions and after 3 months you may lead a normal life.

A.  Please find below the answers to your queries: 1. I think six to eight weeks of rest would be sufficient provided there are no complications. Please consult your surgeon regarding this. 2. There is no mention of the type of hernia repair performed and whether a mesh was used. Many surgeons do recommend an abdominal binder and three months should be sufficient period of time to wear it. The binder helps by providing support to the repaired abdominal muscles. By three months the tensile strength of the wound is approximately 95% complete and this is why the binder is recommended at least for three months. However, not all surgeons recommend its use and it is left to the discretion of the surgeon taking in to account various factors. If your surgeon had recommended its use you should wear it. 3. As regards precautions, there should not be excessive straining or lifting of heavy weight. A hernia occurs when there is a weakness or defect in the abdominal wall through which the abdominal contents (intestines) protrude out. In your case the previous incision was the point of weakness and that is why it is referred to as an Incisional Hernia. SAIO refers to sub-acute intestinal obstruction and a strangulated hernia means that the blood supply to the herniating intestine has been compromised. The operation involves reduction of the contents of the hernia and replacing them into the abdominal cavity and repairing the defect or weakness of the wall. 4. There are no dietary restrictions and after 3 months you may lead a normal life.

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