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
A week or two after a hernia repair, many patients notice a lump in the same place the hernia used to be, and fear the operation has failed.
In the large majority it has not. The space the hernia used to occupy fills with fluid or a little blood while the body heals, and that collection can look and feel remarkably like the original hernia.
Telling the four apart
| What it is | How it feels | When it appears | What usually happens |
|---|---|---|---|
| Seroma | Soft, smooth, not very tender. Little change on coughing. | First few weeks. | Absorbed on its own over several weeks. Needling is avoided. |
| Bruising | Flat discolouration that fades through purple, green and yellow. | First week. | Settles by itself. Common in the groin, scrotum or thigh. |
| Haematoma | Firmer, more painful, sometimes tense. | First days. | Most settle. One that is enlarging quickly is seen promptly. |
| Recurrence | Bulges on standing and coughing, flattens on lying down. | Usually months to years later. | Examined, and confirmed on ultrasound if unclear. |
If a new swelling is worrying you after a repair, send a photograph and the date you first noticed it.
A seroma is a collection of clear tissue fluid in the space left by the hernia sac. It is common after laparoscopic and robotic groin repairs of large hernias, and after large ventral repairs.
It feels soft and smooth, is often not very tender, and does not change much on coughing, because it is sealed off from the abdomen.
Most are absorbed over several weeks. Needling them is usually avoided, because it can carry infection into the space where the mesh lies. One that is large, tense, or still there after months is reassessed.
Bruising spreading into the groin, scrotum or thigh is common in the first week and fades through purple, green and yellow.
A haematoma is a larger collection of blood. Firmer, more painful, sometimes with tense swelling. Patients on blood thinners are more prone to it. Most settle, but one that is enlarging quickly needs to be seen promptly.
A recurrence usually appears later, often months to years after the repair, and behaves like the original hernia. It comes out on standing and coughing and goes back on lying down.
An early lump that has a cough impulse and reduces is examined carefully, and an ultrasound separates fluid from a hernia.
Signs that mean you should call the same day
These point to infection rather than a simple collection. An infection near mesh is treated differently from a surface wound infection, which is why it is worth reporting early.
Most likely not. A seroma or bruising at that stage is common and usually settles. An examination, and if needed an ultrasound, will confirm.
Most are absorbed over several weeks; some take longer. Persisting or enlarging ones are reassessed.
Usually not, because draining risks introducing infection into the mesh space. It is considered only if the seroma is large, tense or persistent.
Bruising and swelling tracking into the scrotum is common after groin repair and settles over one to two weeks. Rapidly increasing or very tense swelling should be seen.
Fever, spreading redness, discharge from the wound, rapidly increasing swelling, or pain that is getting worse rather than better.
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
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