Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Robotic Hernia Surgeon · Apollo Hospital, Bhat, Gandhinagar · Gota OPD, Ahmedabad
In short
Many people who need a hernia repair take a medicine that thins the blood. Aspirin or clopidogrel after a heart attack or a stent. Warfarin or one of the newer anticoagulants for an irregular heartbeat, a replaced valve or a past clot.
Those medicines are there to prevent something serious. A hernia repair is usually a planned operation. That difference in stakes shapes every decision on this page.
Do not stop any blood thinner on your own.
Stopping the wrong one at the wrong time, particularly soon after a coronary stent, can cause the stent to block. The plan is made jointly with the doctor who prescribed it, and it is written down.
A hernia repair creates a space in the tissues where the mesh sits. Blood can collect in that space. The result is a haematoma: swelling, pain and bruising, which sometimes needs draining and raises the chance of infection.
The more the blood is thinned, the more likely that is. Against it sits the risk of a clot, a stroke or a blocked stent if the protection is taken away. Both risks are real, so the answer is a plan rather than a rule.
What usually happens to each medicine around a planned repair
| Medicine | Before surgery | Afterwards |
|---|---|---|
| Aspirin, for heart protection | Often continued right through the repair. | Nothing to restart, because it was never stopped. |
| Clopidogrel, prasugrel, ticagrelor | The hardest group. After a recent stent this is usually the reason to wait. | Restarted on a day agreed with your cardiologist. |
| Warfarin | Stopped for a set number of days and the clotting level checked. | Restarted once the bleeding risk has passed. Some valves need a bridging injection. |
| Apixaban, rivaroxaban, dabigatran | Stopped for a period set by the drug and by your kidney function. | Restarted on the day written in your discharge notes. |
Bring the name and dose of every medicine you take, and your cardiologist's details, to the consultation.
The exact number of days is worked out for you. It depends on the drug, on why you take it, on your kidney function and on the size of the repair. It is not a number to copy from another patient.
Where a stent is recent, the planned repair waits. It waits until the heart doctor is happy that one of the two medicines can be paused for a few days.
A patient on blood thinners gains from careful handling of the tissues. A repair that opens no more space than it needs also helps.
The route is chosen on the hernia first. Open, keyhole or robotic. The bleeding picture is part of that talk.
Afterwards the day each medicine restarts is stated in writing. Early swelling in the groin or the wound is reported rather than watched.
Report any of these early. They are easier to deal with on the day they start.
A trapped or strangulated hernia is operated on whatever the medicine chart says. The anaesthetist and the physician manage the blood thinner around the emergency.
That is one reason a hernia in a patient on these medicines is worth planning early, while there is still a choice about timing.
Not without instruction. Aspirin for heart protection is often continued. Your surgeon and physician will decide together.
Usually the planned repair is deferred until your cardiologist agrees that one of the antiplatelet medicines can be paused safely. A hernia that becomes trapped is treated as an emergency whatever the timing.
It depends on the medicine and the size of the repair. The restart day is written into your discharge instructions.
Any repair carries some bleeding risk on blood thinners. The route is chosen on the hernia, with the bleeding profile taken into account.
Rapidly increasing swelling, tense bruising or pain at the repair site. Report it early.
The main page on this site is robotic hernia surgery in Ahmedabad. These cover the neighbouring questions.
Where to find us
Dr Harsh Shah, MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Shah's Gastro, Cancer & Robotic Surgery Centre
Apollo Hospital, Bhat, Gandhinagar
Gota OPD, Ahmedabad
Bring your reports. Second opinions are welcome.
Swasth Parivar: twice a month, practical advice on recovery, diet and warning signs. No advertising. Stop any time.
Your number is used for these updates and for the clinic to reach you. It is never sold or passed on. To stop, reply STOP on WhatsApp.