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Hernias: Causes, Treatment and Return to Work Impacts

An in-depth presentation on hernias was delivered by general surgeon Dr Ted Heffernan at the recent mlcoa educational event held in Melbourne on 23rd July.

In this session, focus was placed on how hernias are diagnosed, treated and the prognosis for recovery and return to work following operative treatment.  The session was tailored to assist claims operators with useful information relating to hernias as the causative factors can be difficult to identify and separate in some circumstances.

Dr Heffernan commenced the session discussing factors causing hernias.  Dr Heffernan defined that hernia is a protrusion of organs through a weakened section of the abdominal wall and caused through physical exertion such as lifting, sudden abdominal strain, chronic cough/sneezing and can sometimes be congenital. 

Dr Heffernan advised the common features of hernias include groin pain and the appearance of a lump.

The presentation covered the different types of hernias including inguinal hernias which are very common, occurring in nine out of 10 hernias.

Inguinal hernias are also more common in the male population than female due to the weak spot which usually occurs in the inguinal canal.

Dr Heffernan discussed other less common hernias such as congenital hernias (developed at birth) and ‘Sportsman’ hernias (i.e. groin injury) which may also occur from straining.

Hernias do not go away on their own and may require surgical repair.  Hernia repair is the most commonly performed operation with a risk of three per cent recurrence rate.

Dr Heffernan discussed the different procedures to repair hernia (i.e. open surgery, mesh plug method and laparoscopic surgery) and possible post - operative complications, which can include, DVT and wound infections due to a foreign body.

He raised the possibility that an individual may have persistent groin pain even though surgery is successful and it is very difficult to determine if the pain is ‘genuine’ pain.  However, it can be expected that the groin pain will slowly resolve approximately over a six month period.

Dr Heffernan advised that in general, wound healing is complete within two weeks post-operatively and full strength healing of the fibrous tissues can be expected in six weeks.  However, recovery may take longer in elderly people and this will depend on the individual’s fitness level.

In relation to return to work post-operatively, Dr Heffernan advised that it is possible for an individual to return to sedentary duties within two weeks, with gradual increase in lifting tolerance of greater than two kilograms after six weeks.  A return to full duties can be expected between six to eight weeks as full strength healing would have occurred by this time.  

Dr Heffernan opined that physiotherapy is not indicated as part of post-operative treatment usually, but can be of help where there is persistent post-operative groin pain.

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