Preparing for your surgery and your healthcare circuit are developed in the medical office. But following the initial consultation and after having received a lot of information orally and through files, you will probably still have questions.
There are a number of Question/Answers to help you.If everything is not clear in your mind, do not hesitate to contact us, we will be able to enrich the chapter with you.​
Topics covered:
Groins Hernias
Are groin hernias common?
130,000 hernias are operated on each year in France.
Nearly one in three men will be operated on for a groin hernia, there may be a family predisposition.
The groin hernia is 10 times less common in women, hernias in women are often femoral (40%) and in this case must be operated on quickly.
What is your experience in treating groin, umbilical and epigastric hernias?
Trained in the service of René Stoppa, one of the precursors of modern techniques for hernia repair with a large prosthesis (mesh, tulle, etc.), I have always favored this design, first by laparoscopic surgery, and since 2001 using techniques that are resolutely minimally invasive (Ugahary, MOPP, TIPP). Learn more :
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Lien 3 : Technique F.Ugahary académie de chirurgie
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Can be used for practically all types of groin hernias and all types of patient, especially the oldest and most fragile. Since 2001 about 3000 hernias have been treated, the patients being specifically followed for 2 years, our scientifically analyzed results are the subject of regular communication in international congresses.
I have an intermittent bulge in my groin what should I do?
A bulge in the groin that comes out when standing or coughing and goes back when lying down is typical of a hernia. A consultation with a specialist is necessary in all cases in order to confirm the diagnosis and define the action to be taken. There is no need to have an ultrasound performed.
Is there medical treatment for my hernia, can I wear a truss for hernia?
There is no medical treatment for groin hernias.
Support belt or truss for hernia were often proposed in the past because of the poor results of surgery (many recurrences).
Recurrence is now exceptional in my experience, it usually requires surgery.
I have a bulge in the fold of the groin at the root of the thigh, I am told that it is a femoral hernia, what should I do?
Femoral hernia is rare in men but it represents 40% of hernias in women. It is statistically the type of hernia that is most frequently complicated. This type of hernia must therefore be treated without urgency but as quickly as possible before the complication. The complication can manifest itself either by the strangulation of fat, with the presence of a very hard bulge, more or less painful, sometimes inflammatory, or by the strangulation of a digestive loop, with abdominal pain, nausea or even vomiting, urgency then becomes absolute with the need for immediate hospitalization.
My hernia is suddenly painful, it is no longer reducible and I feel nauseous, what should I do?
These symptoms are typical of hernia strangulation. It is urgent to go without delay to the nearest emergency department. A simple clinical examination may be sufficient to confirm the diagnosis. Emergency surgery should be performed immediately. If the bowel has been strangulated for more than 4 to 6 hours it may need to be resected. If he has been strangulated for less than 4 to 6 hours, he can be reinstated and the intervention will be simpler.
What happens if I don't have my hernia operated on?
For a very small and painless hernia, nothing will happen.
For a femoral hernia (small hard bulge in the groin fold in women), or for a very large inguino-scrotal hernia in men, or for a very painful hernia, the risk of complication is higher and the intervention must be the rule within a time limit to be defined.
The complication is then the strangulation of the hernia with intestinal obstruction to be operated on urgently. The vital risk is at stake in the very fragile or very old patient.
For medium-sized and asymptomatic hernias, the risk of acute complication is very low, it is possible to program the intervention according to your schedule, or simply to monitor at first.
But in all cases, the presence of a hernia must give rise to a consultation with a specialist surgeon who will advise you on what to do.Ma hernie de l’aine peut-elle régresser ou même disparaître?
La hernie est secondaire à l'affaiblissement d’un tissu (fascia transversalis) là ou la paroi n’est pas renforcée par du muscle. Cela est irréversible et s’aggrave habituellement progressivement. Il n’y a pas de rééducation possible.
Le remplacement du tissu déficient par un tissu synthétique (le voile, la prothèse) est la base du traitement chirurgical.
Can my groin hernia regress or even disappear?
The hernia is secondary to the weakening of a tissue (fascia transversalis) where the wall is not reinforced by muscle. This is irreversible and usually gets progressively worse. There is no rehabilitation possible.
The replacement of the deficient fabric by a synthetic fabric (the veil, the prosthesis) is the basis of the surgical treatment.
I have a right groin hernia, should I have surgery on the left preventively at the same time.
The pre-operative examination that I will carry out will make it possible to detect a hernia on the other side. Its treatment will then be proposed at the same time and in outpatient surgery.
In the absence of hernia on the other side, do not operate preventively because you will probably not have a hernia on this side (in 80% of cases).
I am over 80 (or over 90), should I have my hernia operated on as it is starting to bother me?
Your hernia should not be underestimated.
“Cold” hernia repair is no more dangerous at your age in our experience.
Emergency surgery is much more serious, especially if you are in occlusion.
If your hernia is very advanced or has an impact on your activities of daily living, it must be operated on because it can cause you to lose part of your autonomy.
Our minimally invasive technique (MOPP, Ref)(MOPP), with a lighter anesthesia and on an outpatient basis is adapted to this situation
Should a prosthesis be placed to treat my hernia?
Adult surgery usually requires the placement of a prosthesis for a better result. It is not a “plate”, but a tulle or a synthetic veil that will be incorporated by your fabrics.
I am specialized in this field having already developed prostheses of parietal reinforcement.
What is the difference between open, laparoscopic, robotic surgery?
What is the difference between open, laparoscopic, robotic surgery?
Open surgery includes interventions of the “Lichtenstein technique” type.
They are reputed to give more postoperative pain. We only use them when other techniques are contraindicated.
The laparoscopic technique is widely used in France, but less indicated
in very frail or very old subjects. This is why I abandoned it in favor of a less invasive technique, the MOPP(MOPP) technique, indicated for everyone.
Robot-assisted surgery is only exceptionally used in France, it is very expensive, with no benefits for the patient.
I have a heart history, I am on anticoagulants, should I have my hernia operated on which is starting to bother me when I walk?
Unless the general condition is very precarious, it is almost always possible, and therefore indicated, to operate on a groin hernia in this situation and preferably “cold”.
​The decision to intervene and the preparation for the intervention are carried out in collaboration with your cardiologist who will, if necessary, carry out a specific assessment. The management of anticoagulants is subject to the latest recommendations in force. Monitoring will focus on the need to perfectly manage the prescription of anticoagulants.
Under these conditions, it is possible to minimize the risk of specific complications. If the risk seems greater than the expected benefit, the hernia will not be operated on.
I have to be operated on for a groin hernia, how long does the operation take?
The duration of the intervention is very variable depending on the type and size of the hernia.
A simple hernia never operated before may require 30 to 45 minutes.
A very large and old hernia may require more than an hour of intervention as well as a hernia that has already been operated on several times.
The post-operative follow-up does not vary specifically according to the duration of the intervention which will most likely be performed on an outpatient basis even in the event of a long-term intervention.
I have to be operated on for a groin hernia, what type of anesthesia is it?
Depending on the techniques, hernia surgery can be performed using all types of anesthesia.
For our techniques, we offer a "light" general anesthesia without intubation of the trachea and without the use of curare most often. I am no longer in favor of local anesthesia which I practiced a lot. I also gave up spinal anesthesia which has some specific drawbacks. The anesthesiologist will inform you precisely about the technique.
I have to be operated on for a groin hernia, what is the risk that the hernia will come back after the operation?
The risk that the hernia reappears after its surgical treatment is possible, this is called recurrence. The recurrence rate depends on the type of procedure, the technique used and the experience of the surgeon. The average rate in France is at least 3%. The rate published by specialists is around 1%. It is less than 1% in my experience. My results are checked by an independent doctor (https://www.club-hernie.com/fr/).
Is the intervention painful, how do I manage?
Pain management is planned from the preoperative consultation.
A prescription for analgesics will be given to you and explained, it is adapted to your particular case, according to your current treatment, your intolerance to anti-inflammatory drugs or opioids…
See more on our post: “Postoperative pain, an essential concern in the surgical process”
It is decided to operate my hernia what should I do or not do before the intervention?
It is usually contraindicated to carry out intense physical efforts, but
concerning an uncomplicated and not very painful hernia, you must continue your usual activities, or even increase them, such as walking every day on flat ground, for example. This is particularly true for the elderly where stopping all activity in the days or weeks before the intervention will make it longer and more difficult to return to normal activities after the intervention. Similarly, sports practice if it was not responsible for significant discomfort can be continued before the intervention, while proscribing of course unreasonable efforts increasing abdominal pressure.
In what position will the prosthesis used to treat my groin hernia be placed?
In the technique that I usually use, the prosthesis introduced through an orifice on the side of the hernia is positioned in the thickness of the abdominal wall between the peritoneum and the bladder in depth, the muscular plane on the surface. I therefore do not penetrate inside the belly, and the prosthesis is not in contact with the viscera, it is placed in the deep part of the wall, it is therefore not palpable, except in a very thin subject. The induration of the wall during the few weeks after the operation is due to the small approach first and not to the presence of the material.
I am not reassured to leave the clinic the same day of the intervention should I not stay at least a day or two.
Carrying out hernia repairs (as well as hemorrhoid surgery and gallbladder surgery) on an outpatient basis is practically the rule.
Outpatient treatment is beneficial regardless of the patient's age and even if he or she has a notable history.
The surveys carried out confirm this, such as that of the High Authority for Health (HAS):
See the blog post: "Les bénéfices de la chirurgie ambulatoire"
When can I resume my sports activities after my hernia surgery?
There are no recognized links between early return to sport and a risk of complication or recurrence after surgery for a groin hernia.
Walking is therefore possible and even recommended immediately after surgery.
More intense physical activities are then limited by pain or discomfort in the groin. You have to adapt your activity so that this discomfort is acceptable, with the prescribed analgesics.
It is then possible to gradually resume after two to three weeks a more intense sports practice
When can I resume sexual activity after hernia surgery?
As with sports, there is no risk of complications in quickly resuming sexual activity. But it will be limited initially by the pain which may even lead to an inhibition which may be marked temporarily. But hernia surgery poses no risk to sexual function.
How long will I be off work after groin hernia surgery?
There is no specific rule. There is no absolute prohibition.
A break of several weeks is however recommended for very physical trades, forced laborers, certain professions at risk (construction trades, etc.).
Prolonged sitting can be difficult the first week (administrative work, etc.).
The work stoppage must be planned precisely before the operation, and its duration can be adapted afterwards (early return, extension). The certificate is given on the day of the intervention.
When can I get back behind the wheel after my intervention.
If the resumption of driving is prohibited the same day of the intervention, it is then possible depending on the pain which could lead to a risk of accident.
Caution is required for road professionals (Taxi, public transport, etc.), the work stoppage must then cover a period of one to two weeks after the intervention.
After my inguinal hernia surgery will I have a scar?
We perform a minimally invasive procedure, with a single orifice near the groin.
The scar measures approximately 3 cm covered by adhesive strips: the steri-strips.
The scar is in the jersey, barely visible after several months.
You can shower the next day, and replace the dressing yourself without any special care. The strips are removed at the office during the first appointment.
How do I feel after the procedure, will I have any swelling, a bruise?
How do I feel after the procedure, will I have any swelling, a bruise?
You can and should walk for a few hours after the procedure and the surgery is usually on an outpatient basis.
You will have treatment available to you to manage the pain.
You will have swelling at the level of the small scar, it will disappear completely very gradually. A bruise or a bruise is possible, sometimes spectacular (especially if you are taking antiplatelet drugs), this is usually not serious and will disappear in about ten days.
Painful or progressive swelling requires a call or even a check-up at the office
In the event of intervention on very large hernias, in particular which descend into the purses for men, there is very frequently a large swelling between the groin and the purse, it is usually little or not painful but may require months before disappearing spontaneously.
Hemorrhoids
Is hemorrhoid surgery always very painful?
I use a less invasive technique, it is the technique of ligation of the hemorrhoidal vessels under Doppler control with associated mucopexy (the hemorrhoidal packages are ligated and reintegrated at the rectal level, (HAL-RAR technique). The pain can be significant , but are on average less intense and of shorter duration than with the classic techniques of the Milligan and Morgan type.There is no specific treatment, but some hygiene and dietary rules must be respected.
I have hemorrhoids, can I play sports?
Yes of course you have to keep a regular physical activity. It is necessary to favor physical activities without trauma to the buttocks and perineum and to avoid violent sports.
I had a hemorrhoidal attack. What should I do to prevent it from coming back?
It is necessary to fight against constipation, chronic cough, obesity, avoid alcohol consumption, spicy dishes, sedentary lifestyle. Avoid heavy lifting
You should favor a diet rich in fiber, drink plenty of water and exercise regularly.
Can hemorrhoids occur after surgery?
Depending on the type of hemorrhoids, the type of operation. After HAL Doppler-RAR type surgery ( our favorite procedure), some residual hemorrhoidal packages may persist in 20% of cases. It will sometimes be indicated to intervene again if the symptoms reappear, but in less than 3 % according to our experience.
How long will my work stoppage last after hemorrhoid surgery?
It is possible to resume physical work and sports activities on average ten days after the operation.
Am I at risk of anal incontinence after hemorrhoid surgery?
The surgery does not affect the sphincters and except for exceptional complications there is no risk of incontinence. However, rarely, one can observe incontinence with loose stools or gas, especially if there was already sphincter weakness before the intervention. it should be noted that hemorrhoids participate for a small part in anal continence, their treatment can then explain this incontinence to gases and liquid stools, but which is very rarely noted.
I have hemorrhoids for a very long time, am I at risk of getting anal or rectal cancer?
No there is no relationship between hemorrhoids and cancer risk. However, in the event of bleeding through the anus, it is often indicated to check the absence of rectal or colon polyp associated with hemorrhoids, and therefore to have a colonoscopy performed.
I have bleeding through the anus, are my hemorrhoids the cause?
Anal bleeding is of haemorrhoidal origin or sometimes due to a fissure or anal fistula in more than 90% of cases, but it is always necessary to ensure by proctological examination (rectal examination, etc.) and by endoscopy (proctoscopy and complete colonoscopy) that there is no other cause of bleeding (rectal or colonic polyps or more advanced malignant lesions, etc.). Any bleeding or abnormality in the anus must be examined by the gastroenterologist or the proctologist surgeon.
I have anal skin tags, should I be worried?
After the natural evolution of hemorrhoids, or after surgery, more or less significant of skin tags may persist around the anus. They are painless but can be troublesome especially for hygiene. When they are very advanced, a resection of this excess skin can sometimes be indicated.
Gallstones
I have stones in the gallbladder and I am not in pain, what should I do?
It is very common to have one or more stones in the gallbladder. About 10% of adults and 20% of people over 65 have it. In 80% of cases there are no symptoms and the stone was found by chance (ultrasound, etc.), and nothing should be done. But if there is, even rarely, pain in the pit of the stomach or under the ribs, it is necessary to consult. An operation should be performed if the stone is responsible for the pain.
Stones in the gallbladder have been discovered, what should I do?
If the discovery of stones is secondary to an ultrasound or CT scan for something else and you do not have stomach pain, or if the pain is not in the pit of the stomach or immediately under the ribs (hepatic colic), there is nothing to do on your gallbladder, you can live with these Gallstones.
If you have pain in the pit of the stomach or under the ribs, especially after meals (hepatic colic), then you have to consult a visceral surgeon. After consultation and completion of additional examination (biological assessment…) and if the stone is responsible for the pain, the gallbladder will have to be removed to solve the problem of pain and above all to avoid more serious complications (infection, jaundice, acute pancreatitis…)
I have stones in the gallbladder and I had pain (hepatic colic). Is there a treatment to avoid having surgery?
There is no diet or medical treatment to remove the risk of complications. Cholecystectomy is inevitable to avoid complications that are sometimes very serious and fatal (infection of the gallbladder and bile ducts, acute pancreatitis, etc.). While waiting for the operation, a fat-free diet (animal and vegetable) is strongly recommended. Treatment with ursolvan (ursodeoxycholic acid), which can dissolve small stones of pure cholesterol, has no efficacy and no indication.
Unlike urinary stones it is not possible to break (lithotripsy) the gallstones.
The pilonidal sinus.
I have a oozing out of the crease between my buttocks for months, with swelling that has emptied recently. What is it about ?
A chronic oozing at this level is probably due to a pilonidal sinus disease. that is, a cavity under the skin containing hair. It is necessary to consult for an examination which will generally easily confirm the diagnosis. sometimes an ultrasound can complete the examination.
Surgery should usually be considered to treat the lesion and prevent it from getting worse.
I have an increasingly painful red bump in the fold between my buttocks, I am taking antibiotics, what should I do ?
It is an infected pilonidal sinus disease with abscess, you must consult a surgeon urgently. In the presence of an abscess an incision must be made immediately, allowing rapid relief of pain and stopping the infectious process.
Like several members of my family, I have a pilonidal sinus disease, that has been bothering me for months, I want to have an operation, but I cannot be immobilized for weeks ?
The treatment of the pilonidal sinus has evolved. Most often, it is now possible to avoid the classic mutilating surgery requiring months of nursing care responsible for disrupting school, university, professional and sports life... For this I perform a minimally invasive treatment through a small incision and use a camera. The postoperative course is much simpler with a rapid resumption of activities.
I have a pilonidal sinus and I want to have surgery, but it seems that it comes back ?
Even after aggressive and mutilating treatment and after complex and sometimes painful local nursing care, the pilonidal sinus disease can recur. The complexity and duration of post-operative nursing care and the pain can be the cause of school or university failures or compromise professional integration. The minimally invasive endoscopic approach allows an outpatient treatment, a faster return to activities. The risk of recurrence is the same, but again accessible to endoscopic treatment. So there is much less impact on daily life.
I have a pilonidal sinus is it serious?
The pilonidal sinus may be painless or give only a small oozing for months or even years. The disease can gradually worse and spread throughout the crease between the buttocks, towards the buttocks, towards the anus. It can suddenly become complicated and give rise to a very painful abscess. It is therefore always necessary to consult as soon as the diagnosis is suspected in order to study the best therapeutic tactics by avoiding as much as possible painful mutilating treatments, a source of significant disruption of personal life.