Hernia
Diagnosis

  • History & examination
  • Ultrasound
  • CT

Surgery Fitness Assessment 

  • Exercise tolerance
  • ECG/echocardiogram
  • Lung function tests
  • Cardio-pulmonary exercise testing 

Surgery
Type

  • Which anaesthesia?
  • local anaesthesia
  • spinal anaesthesia
  • general anaesthesia
  • Keyhole or open surgery?

Aftercare & Lifestyle Impact

  • Driving
  • Return to work
  • Return to activities

Day-case or in-patient surgery?

Most groin hernias and most paraumbilical/umbilical hernias are corrected as day-case operations.

The majority of incisional hernias and parastomal hernias require 1-5 nights in hospital depending on the complexity of the hernia and the operation required.

Laparoscopic or open surgery?

Laparoscopic ('keyhole') surgery is often suitable for unilateral groin hernias (inguinal and femoral), bilateral groin hernias, obturator hernias and some very small ventral abdominal wall hernias.

Open surgery ( involving 'a cut over the hernia') is generally advised for umbilical/paraumbilical hernias, most incisional and  parastomal hernias, and many rarer hernias eg traumatic, perineal, Spigelian. 

https://www.surginno.com/products/

Improving the outcome of surgery

There are several 'patient related factors' which should be optimised prior to surgery:

  • weight: ideally a BMI of 30 (35 maximum for incisional hernia repair)
  • avoidance of smoking
  • optimisation of any other significant medical condition eg diabetes, chest and heart disease
  • temporary cessation of any blood thinning drugs if possible
  • early mobilisation post-op
  • following advice re post-operative care

Abdominal wall reconstruction

Abdominal wall reconstruction is a specific term for repair of large or complex ventral or incisional hernias.  The aim of the operation is to re-join the abdominal wall muscles in the midline of the abdominal wall. 

Abdominal wall reconstruction may often necessitate a CT scan to aid surgical planning.  

Abdominal wall reconstruction may require injection of Botox a few weeks before surgery to increase the chances that the abdominal wall muscles can be re-joined.

Abdominal wall reconstruction typically takes around 3-5 hours. Typical length of stay is around 5 days. 

How to arrange a consultation

Private

https://www.spirehealthcare.com/spire-leeds-hospital/consultants/mr-ian-botterill-c3541447/

Outpatient appointments: 

0113 218 5908

0113 218 5909

Sec: 0113 218 5668

NHS

  • consult GP
  • obtain referral to Leeds Teaching Hospitals NHS Trust
  • appointments at St James' University Hospital or Wharfedale General Hospital.