FAQ (Frequently Asked Questions)

A

Abdominal bandage

After umbilical, incisional or upper abdominal hernias with mesh insertion, consistent wearing of an abdominal bandage for 4-6 weeks is recommended. This provides increased protection against wound water formation (seroma) and a new hernia (recurrence). Most patients find wearing it comfortable after a few days. 

ASS

The blood thinner ASA (acetylsalicylic acid) or also known as Aspirin® should be paused for 8 days before surgery if possible. In some patients this is not possible (heart attack, heart stent, stroke), so that surgery can also be performed with ASA, but with a slightly increased risk of bruising after the operation.

B

Bathing

A full bath should only be given after 2 weeks so that the wounds do not tear open.

C

Clothes

You may wear whatever you like. Clothes should not be too tight, after abdominal wall hernias belts may press on the wound if necessary. In case of mesh implantation in the abdominal wall, more clothes should be worn because of the abdominal bandage.

Control

As a rule, after outpatient surgery, patients present to us the following day for a wound check and dressing change. Often we perform another control after 5-7 days. An ultrasound examination can be performed after 3-6 months.

Cooling

In the first 3 days after an open operation, it is advisable to cool the wound with a Cool Pack wrapped in a tea towel 3 times a day for approx. 30 minutes to promote decongestion of the wound. Please never place the Cool Pack or ice directly on the skin.

E

ELAR-plus

This technique focuses on reconstruction of rectus diastasis associated with hernia. Through a small incision above the umbilicus, the midline is gathered and mesh is inserted for reinforcement. The procedure is also described as Endoscopic-Assisted Linea Alba Reconstruction plus Mesh Augmentation.

F

Fever

In the first 48 hours after surgery, the temperature may rise up to 38°c. This should not worry you. If the temperature exceeds 38°c, be sure to present again.

Follow-up care

see "Herniamed" 

Food

Before surgery under general anesthesia, you must be fasting for 6 hours, which means no food intake, no smoking and, for example, no coffee with milk. For outpatient surgery, you may drink still water or tea without milk up to 2 hours before the anesthesia.

After the operation, you should eat a light diet on the day of the operation and avoid flatulent foods such as bean or lentil dishes for the next few days.

G

Getting up

On the day of surgery, you will be allowed to get up 1 hour after surgery, accompanied by an attending.

H

Herniamed

This is a quality assurance study of hernia surgeons in Germany, Austria and Switzerland with over 1.300,000 patients. After patient consent, the data is evaluated for scientific questions. In addition, there is a voluntary survey about complications and the state of health after 1 year, 5 years and 10 years.

I

Inability to work

Operations on the abdomen can be painful. Depending on the professional load, the duration of incapacity for work is 1-2 weeks for light load and up to 4 weeks for heavy load.

Incarceration

The likelihood of incarceration of an inguinal hernia during a lifetime is 2.7% and 6% for an umbilical or upper abdominal hernia. Incarceration is more common in the groin area in women.

IPOM

The classic minimally invasive technique using laparoscopy for all forms of hernia up to 8cm. The abbreviation IPOM stands for Intraperitoneal Onlay Mesh. In this case, the mesh lies in the abdominal cavity. Small meshes can also be inserted on an outpatient basis as open IPOM.

L

Load

After inguinal hernia surgery, you can immediately perform all activities of daily living. Jogging, cycling and swimming only after 2 weeks and full physical load (e.g. weight training) after 4 weeks. In the case of abdominal wall hernias with mesh insertion, full weight-bearing should only be performed after 6 weeks. In the case of repeat hernias and major operations, after individual consultation with the surgeon.

M

MILOS

The MILOS (Minimally Invasive Less Open Surgery) technique is a mesh placement below the straight abdominal muscle (subway technique). In this procedure, the skin incision is a maximum of 6 cm and the meshes, some of which are large, are placed under camara view. Due to the small skin incision and the absence of mesh fixation, it is a gentler procedure in which the mesh does not lie inside the abdomen. This procedure does not operate on inguinal hernias, for which there are TEP and TAPP.

N 

Mesh

Nowadays, the meshes we implant are lightweight with larger meshes and are made of polypropylene plastic. During minimally invasive inguinal hernia surgery, a mesh of size 10x15cm is always implanted. These usually do not need to be fixed. If it is necessary, then with an adhesive or staples that dissolve. The nets remain in the body for life. In the case of abdominal wall hernias, we use nets with a special coating, so that there is very little adhesion to the inside of the abdomen.

O

Outpatient surgery

We perform this operation in our practice in Lankwitz. The patients go home 1 hour after the operation accompanied. For inpatient operations, on the other hand, patients stay in the hospital for at least one night.

Operation day

On the day of the operation, please come to the hospital or our practice on an empty stomach. Blood-thinning medications must be paused for 1-3 days beforehand, depending on the active ingredient. For outpatient surgery, wear comfortable clothing and remember to bring a companion to pick you up from the practice.

P

Pain

The pain behavior of patients varies greatly. It is important to know that stronger pain can occur in the first 5 days. This is less with inguinal hernias than after abdominal wall hernias. You should take the painkiller prescribed by us (ibuprofen or novaminsulfone) for the first 3 days, because pain suppression in the beginning is very important for the course of the operation. After an increased load, pain may increase again somewhat after 5-10 days.

Pregnancy

According to current data, women can become pregnant without any problems after inguinal hernia surgery with mesh insertion. This is also possible after umbilical or upper abdominal surgeries with mesh insertion, but the hernia may return afterwards and patients may develop pain.

PUMP

Preperitoneal Umbilical Mesh Plastic (PUMP). Umbilical hernias are treated with a mostly round mesh, which is 5-8cm in diameter and is not placed directly in the abdominal cavity (intraperitoneal position), but is placed on the peritoneum. The technique is also suitable for upper abdominal hernias. Overall, however, only smaller hernias up to 2cm can be treated and in some cases it is technically impossible to perform.

R 

Rectus diastasis

The widening of the midline in the abdominal wall is described as rectus diastasis (rectus=straight abdominal muscle; diastasis=distension). Since there is no gap here, it is not a hernia. Therefore, there is usually no medical indication and the costs of surgery are not covered.

S

Seroma

This is an accumulation of wound fluid that always occurs as a body reaction and can be misinterpreted as a new hernia after inguinal hernia surgery, for example. As a rule, the body reabsorbs this fluid within 4-6 weeks, so that a puncture should absolutely be avoided.

Showering

After all surgeries, showering with a shower patch can be done from the 2nd postoperative day, with soap use. In case of prolonged showering, the patch should be changed afterwards. From the 10 postoperative day, plasters are no longer necessary. Shower patches are available in drugstores and pharmacies and are not prescribed by prescription.

Smoking

The less you smoke before a procedure, the better the wound healing. You are not allowed to smoke for 6 hours before a general anesthesia. Every day that you do not smoke after surgery promotes microcirculation to the wound and thus wound healing. Please remember. 

Sutures

In most hernia operations we use self-dissolving suture material, there is no need for sutures. In rare cases, we use staples for larger abdominal wall hernias, which are removed without problems after 12 days.

Sports

After an umbilical or inguinal hernia treatment with mesh insertion (open and minimally invasive), you may jog, cycle and swim after 14 days. After 4-6 weeks you are allowed to do full weight bearing, i.e. weight bearing sports. After major hernia operations and scar hernias, you should not do any sports activities except swimming for at least 6 weeks.

Swimming

After 14 days you may bathe or swim. The wound will then no longer soften.

T

Testicular pain

After an inguinal hernia operation, a pressure pain in the testicle area may occur after 2-3 days. This is caused by wound fluid that accumulates in the small envelope layers around the testicle and is reabsorbed by the body after 4-6 weeks. There may also be a small bruise (hematoma) in the scrotum, which is completely harmless and disappears after 1-2 weeks.

U

Urgency

If an abdominal wall or inguinal hernia has been diagnosed, surgery should take place in the next few months. If there are no complaints, this can be well planned.

W

Women

We could show from our own data at Herniamed that the inguinal hernia behaves differently in women. The risk of incarceration is significantly higher than in men and often a femoral hernia is also present. Therefore, an inguinal hernia in a woman should always be operated on, ideally with mesh insertion using the keyhole technique (TEP/TAPP).

You are welcome to book an appointment online in our appointment calendar DOCTOLIB under the specialty "Visceral surgeon and proctologist" with our doctors. We are looking forward to it.