Urgent Request for your advice on Inguinal Hernia Surgery and Recuperation

[leapfrog]

Hi guys,

I have been diagnosed with an inguinal hernia today:amazed: and been told to seek surgery ASAP because apparently right now it's "OK" (whatever that means). Tomorrow I see the surgeon and they'll probably get me into the carving room in the next few days.

I wanted to know if anyone can give me any advice on the realtionship between this and sports (when I am not diving I run every day) and especially about whether some particular surgical technique should be used over another to prevent recurrance and ensure that I am back to full fitness in the shortest time possible.

I am also interested in the best fitness recuperation program to go back to jogging sprinting and diving.

As a full time scuba professional, my only "worry" is that this might affect my ability as an instructor or as a diver. raying:

All comments appreciated! Thanks in advance. :froggy:

 

[cutlass]

Inguinal hernias broadly fall into 3 types: direct, indirect, and femoral. The first 2 are the most common, guesstimating about 1% and 5% respectively. A direct inguinal hernia is typically the "wear and tear" type; e.g. repeated heavy lifting or straining. The indirect form is typically congenital; i.e. a structural defect/weakness in the passageway which allowed the testicles to descend -- but it's also a feature in females such that the male/female ratio is about 4:1.

There are a couple handfuls of different surgical procedures used (older Bassini and McVay, Lichtenstein, Shouldice, TAPP, TEPA, high ligation for kids, etc.) but my gross simplification is that it's most likely going to boil down to using synthetic mesh material to close and reinforce the defect; i.e. a plug'n'patch procedure. It's still a bit of a toss-up of whether to use an open procedure (i.e. reaching in directly) or a laparoscopic approach. For the open option, one plus is the ability to use local anesthetics; a minus is possibly longer healing time. For the scope option, one plus is a possible quicker return to activity; a minus is the use of general anesthesia. There are other pros and cons and it's obviously best to discuss any such with your surgeon who will be familiar with your situation.

Inguinal hernias are typically handled on an out-patient basis; i.e. in and out the same day. Of course, your return to activity depends on the nature of the defect and any complications. But in general, non-strenuous, especially non-lifting, activity can usually be resumed in about a week. Full but non-heavy lifting activity can be resumed in as little as a couple of weeks. I'd discourage heavy lifting for about a couple months. Possibly except for symptomatic relief, the use of support appliances (i.e. "truss" support) is typically discouraged, especially as a long-term option.

A bit of advice, which pretty much always applies, is to try and get a surgeon who does lots of these operations. Experience counts. (As a rather extreme example of specialization, there's a clinic in Ontario, Canada -- Shouldice, specifically (and there's a unique procedure named for them) -- which exclusively does hernia repairs.)

This link discusses hernias in some detail and has some recovery time info: AHRQ link


More info on laparoscopic procedures can be found on this SAGES link

 

[leapfrog]

Amazing. Many thanks. I saw the surgeon today and he has pencilled me in for November 6th. He is going to opt for an open procedure and local anesthetics. If I have understood correctly, the reasoning is that he wants to put a good mesh and plug in to reinforce the area as much as possible. It seems that I got lucky and that the surgeon is a scuba diver and sporty guy and understands the need for my being back to full steam ASAP.

Once again, thank you for your useful and spot on reply!

 

[Thalassamania]

I had an inguinal repair, exactly like yours, a few years ago. I was out of the water for about a week (dry suit kept the incision from getting wet). I was back in a wet suit in two weeks.

 

[leapfrog]

Thanks Thal. Even though it's just one of those nuisance things, it sometimes gnaws on your mind about it might affect work, hauling tanks and weights and so on. This is about the silliest darn thing that's ever happened to me. I appreciate your words. Hope all s well with you.

 

[Thalassamania]

All is fine, thanks. Do be careful hauling and lifting. While I was back in the water, I had someone hang my weights and rig off the side on lines and I did not try and get back to full function for two weeks.

 

[ian@1904]

I had a hernia repair some six years ago. It was a success.
Be prepared for quite a lot of discomfort for a week or two. In my case it took three months before the twinges stopped. My GP reckoned that the surgeon had had a good rummage about inside me when doing the repair. Here in the UK we are not allowed to drive for two weeks after this operation, so I had to work from home during the recovery

 

[Tomeck]

I had a very big hernia and I couldn't walk along time more than 100 meters, I was operated, then three later, I dive again with a tank tek.

 

[TSandM]

As has already been said, be prepared for some significant postoperative discomfort. It may be several weeks before you are walking upright again

Lifting and straining are the best way to encourage a repair to fail. Most surgeons will recommend that you do NO heavy lifting or straining for at least six weeks post op. Exercise can be resumed, once you are comfortable enough to do it, but anything involving lifting weights needs to wait.

 

[Jrock1062]

I had a hernia a few years back i had it done laprascopically best decision i ever made I was a bodybuilder at the time and tore it up real bad 3 layers of mesh and about 2 months worth of light exercise all better now but i am glad i didn't have them cut me they say thats worse than the 2 little dots and yeah it hurt a lot