Open Herniorrhaphy

WHAT YOU SHOULD KNOW:

• A herniorrhaphy (her-nee-or-uh-fee) is surgery to fix a hernia (her-nee-uh). An open hernia repair means that an incision (cut) is made over the hernia. Through this incision, your caregiver sews the muscle and tissue wall to make it stronger.
  
  
• A hernia is a weakness in the abdominal wall through which inner tissue pushes through. It may pouch out and look like a balloon under your skin. Many people refer to a hernia as a "rupture." You may have an inguinal (in-gwih-null) hernia which is in the area where your upper leg and lower abdomen (belly) meet. A man may feel a lump in his scrotum if he has an inguinal hernia. An umbilical (um-bill-ih-kull) hernia is in your belly button. Or, you may have an incisional hernia in a scar from an earlier surgery.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

There are always risks with surgery. You may bleed more than usual or get an infection (in-fek-shun). You could have trouble breathing or get blood clots. Caregivers will watch you closely for early signs of these problems. Call your caregiver if you are worried or have questions about your medicine or care.

WHILE YOU ARE HERE:

• Blood Tests: You may need blood taken for tests. The blood can be taken from a vein in your hand, arm, or the bend in your elbow. It is tested to see how your body is prior to your surgery. You may need to have blood drawn more than once.
  
  
• Call Button: You can use the call button when you need your caregiver. Pain, trouble breathing, or wanting to get out of bed are good reasons to call.
  
  
• Chest X-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing before surgery. Caregivers may also use the x-ray to look for signs of infection like pneumonia (new-moan-yuh).
  
  
• Gown: A hospital gown is needed so that caregivers can easily check and treat you. Caregivers will show you how to put on your gown. You may not be allowed to wear your own bedclothes or undergarments to the operating room. This is because you may need monitors on your skin during surgery. When you feel better you may be able to wear your own bedclothes.
  
  
• Informed Consent:
  
  
  • You have the right to understand your health problem. In words you can understand, you should be told what tests, treatments, or procedures may be done to treat your problem. Your doctor should also tell you about the risks and benefits of each treatment.
    
    
  • You may be asked to sign a consent form. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that gives your doctor permission to do certain tests, treatments, or procedures. This form should tell you exactly what will be done to you. Your doctor should tell you what the risks and benefits of each treatment are before you sign the form. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.
  
  
• IV: An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.
  
  
• Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.
  
  
  • Anesthesia (an-iss-thee-zuh): This is medicine to make you comfortable during surgery. You may be awake or completely asleep. You and your caregiver will decide which type of anesthesia is best for you. Do not sign legal documents for 24 hours after having anesthesia because anesthesia medicine may make your thinking unclear. Ask your caregiver for the anesthesia CareNotes™ handout if you want to know more about anesthesia. Following are the different types of anesthesia.
    
    
    • Local Anesthesia: This is a shot of medicine put into the skin where you will have surgery. It is used to numb the area and dull the pain. You may still feel pressure or pushing during surgery.
      
      
    • Spinal Anesthesia: This is medicine put into your back through a shot. You are awake during surgery but numb below the waist. Feeling returns in about 2 hours.
      
      
    • General Anesthesia: This is medicine given as a liquid in your IV. Or, it is given as a gas through a face mask or a tube placed in your mouth and throat. This tube is called an endotracheal (end-o-tra-kee-ull) tube or "ET" tube. Usually you are asleep before caregivers put the tube into your throat. The ET tube is usually removed before you wake up. You are completely asleep during surgery.
    
    
  • Heart Monitor: This is also called an EKG or an electrocardiogram (e-lek-tro-kar-d-o-gram). It is a painless test to see how your heart is working. Sticky pads (3 or 5) are placed on different parts of your body. Each pad has a wire that is hooked to a TV-type screen. This screen shows a tracing of each heartbeat. Your heart is being watched all the time to make sure your body is handling surgery well.
    
    
  • Pulse oximeter: A pulse oximeter is a machine that tells how much oxygen is in your blood. A cord with a clip or sticky strip is placed on your ear, finger, or toe. The other end of the cord is hooked to a machine. Caregivers use this machine to see if you need more oxygen.
    
    
  • Vital Signs: This includes taking your temperature, blood pressure, pulse (counting your heartbeat), and respirations (counting your breaths). To take your blood pressure, a cuff is put on your arm and tightened. The cuff is attached to a machine which gives your blood pressure reading. Caregivers may listen to your heart and lungs by using a stethoscope (steth-uh-skop). Your vital signs are taken so caregivers can see how you are doing.
  
  
• During Surgery: Caregivers clean your abdomen with soap and water. This soap may make your skin yellow, but it will be cleaned off later. Sheets are put over you to keep the surgery area clean. An incision is made in your abdomen and the hernia is repaired. Caregivers may use a man-made material called mesh to make your abdominal wall even stronger. The incision is then closed with thread or staples. A bandage or adhesive strips are put over the incision.
  
  
• After surgery: You are taken to a room where you can rest. Caregivers will check on you. When they see that you are ready, you may also be allowed to go home. If you are staying in the hospital, you will be taken to your hospital room. Do not get out of bed until your caregiver says it is OK. A bandage is used to cover your stitches or staples. This bandage keeps the area clean and dry to help prevent infection. A caregiver may remove the bandage soon after your procedure or surgery to check the area.
  
  
  • Activity:
    
    
    • You may need to rest in bed but caregivers will help you get out of bed, probably the first day of surgery. Until you are allowed out of bed, you can still exercise your legs in bed. Do this by lifting one leg off the bed and drawing big circles with your toes. Then do it with the other leg. Another good exercise is to lie on your side and pretend to pedal a bike. This makes your legs stronger and stops blood clots from forming. Stop if you become tired.
      
      
    • Your caregiver will tell you when it is OK to get out of bed. Call your caregiver before getting up for the first time. If you ever feel weak or dizzy, sit or lie down right away. Then call your caregiver.
    
    
  • BMs: This is also called having a bowel movement or a BM. Walking really helps to get your bowels moving. It also helps you feel better faster. Foods like fruit, bran, and prune juice can help you have a BM. Drinking water can help too. Caregivers may give you fiber medicine to help make your BMs softer and more regular. This fiber medicine can be bought at drug and grocery stores.
    
    
  • Deep Breathing and Coughing: This breathing exercise helps to keep you from getting a lung infection after surgery. Deep breathing opens the tubes going to your lungs. Coughing helps to bring up sputum from your lungs for you to spit out. You should deep breathe and cough every hour while you are awake even if you wake up during the night.
    
    
    • Hold a pillow tightly against your incision when you cough to help lessen the pain. Take a deep breath and hold the breath as long as you can. Then push the air out of your lungs with a deep strong cough. Put any sputum (spit) that you have coughed up into a tissue. Take 10 deep breaths in a row every hour while awake. Remember to follow each deep breath with a cough.
      
      
    • You may be asked to use an incentive (in-sen-tiv) spirometer (sper-om-ih-ter). This helps you take deeper breaths. Put the plastic piece into your mouth and take a very deep breath. Take the mouth piece out of your mouth and hold your breath as long as you can. Holding your breath pushes the air far down in your lungs. Let out your breath normally. Use your incentive spirometer 10 times every hour while you are awake.
    
    
  • Eating: You may be able to eat when bowel sounds (stomach growling) are heard. Your caregiver will listen to your stomach for bowel sounds using a stethoscope. Ice chips are usually given first and then liquids (water, broth, apple juice, or 7-up). If you don't have problems after drinking liquids, caregivers may then let you eat soft foods. Some examples of soft foods are ice cream, applesauce, or custard. If you do OK with soft food, you may begin eating a regular diet.
    
    
  • Medicines:
    
    
    • Antibiotics (an-ti-bi-ah-tiks): This medicine may be given to help you fight infection caused by a germ called bacteria (bak-teer-e-uh). Antibiotics may be given by IV, as a shot, or by mouth.
      
      
    • Antinausea medicine: This medicine may be given to calm your stomach and control vomiting (throwing up). Pain medicine may upset your stomach and make you feel like vomiting. Because of this, pain medicine and anti-nausea medicine are often given at the same time.
      
      
    • Pain Medicine: Caregivers may give you medicine to lessen your pain. This medicine may be given in your IV, as a shot, or by mouth. Tell caregivers if the pain does not go away or comes back.
      
      
    • Stool Softeners: You may be given stool softeners to keep you from getting constipated (kon-stih-pa-ted). Constipated means it is hard have a BM. Stool softeners make your BM softer so you do not need to strain when having a BM.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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