Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Hernia Surgeon · Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
In short
- An emergency hernia repair treats trapped bowel first and the gap second, so it is a bigger operation with a slower recovery.
- Mesh is often left out when the field is contaminated, so the gap is closed with stitches and repaired properly later.
- Most people go home within a week, but a bowel removal or a stoma makes the stay and the recovery much longer.
Most hernias are repaired on a date you pick, after tests, with time to ask questions. A small number are repaired the same night, because the hernia has trapped bowel.
It is the same hernia and often the same surgeon. It is not the same operation.
Why the operation is different
A planned repair has one job. Put the contents back and close the gap.
An emergency repair has two jobs, and the gap is the second one. The first is the bowel or fat caught in the hernia. If the blood supply has been pinched off for long enough, that tissue dies.
So the surgeon opens, frees what is trapped, and then waits and watches. Bowel that pinks up again is left alone. Bowel that stays dusky has to come out.
Getting to theatre
You arrive through casualty, usually with pain and vomiting. A drip goes up, blood is sent, and a scan is done if there is any doubt about what is going on.
Consent is taken in a hurry, and it covers more than a planned consent does. It includes removing bowel, and it includes a stoma, because neither can be ruled out before the surgeon looks.
That is why the conversation feels heavier than the one before a planned list.
Why mesh is often left out
Mesh is a foreign material. It settles well into clean tissue, and badly into tissue that has bowel contents around it.
If the bowel was never opened, the field is clean and mesh is usually used as normal. If a piece of bowel had to be removed, the field is no longer clean, and putting mesh into it risks a deep infection that is very hard to clear.
So the gap is closed with strong stitches instead. That holds, but it comes apart more often than mesh does, and a proper repair is then planned for a few months later.
How an emergency hernia operation differs from a planned one
| What changes | Planned repair | Emergency repair |
|---|---|---|
| Getting in | A date you choose | Through casualty, the same day |
| The bowel | Pushed back and left alone | Checked, and removed if a part has died |
| Mesh | Used in almost every case | Often left out if the field is not clean |
| Time in hospital | A day, sometimes two | Three days to a week, or more |
| Getting back to normal | Two to four weeks | Six weeks or longer |
Had an emergency repair, or been told you may need one? Bring the operation notes and we can plan what follows.
When a stoma is needed
If a long piece of bowel has died, the two healthy ends are usually joined inside. Sometimes they cannot be joined safely, because the patient is very unwell or the bowel is swollen.
In that case one end is brought out onto the skin as a stoma, and a bag collects from it. Most of these are temporary and are reversed a few months later.
It is uncommon. It is mentioned at consent because it changes the next few months, and nobody should hear about it for the first time afterwards.
Recovery after an emergency repair
Expect a slower course than a planned repair.
Eating starts when the bowel wakes up, which can take two or three days if a join was made. The wound is watched more closely, since infection is commoner here. Three days to a week in hospital is usual, and longer if there was a bowel removal.
Tiredness lasts weeks rather than days. That is the illness as much as the operation.
How to avoid being in this position
Nearly every emergency hernia operation starts as a hernia somebody already knew about.
A hernia that is growing, that hurts most days, or that will not go back when you lie down is a hernia to get looked at, not to live around. A femoral hernia is repaired on the diagnosis.
Planned repair is the smaller operation with the quicker recovery. That is the whole argument for having it on a date you choose.
Frequently asked questions
Is emergency hernia surgery more dangerous than a planned repair?
Yes. The risk is higher, mainly because the bowel may be damaged and the patient is often already unwell before surgery.
Will mesh be used in an emergency hernia operation?
Often not. If bowel had to be removed the field is not clean, so the gap is closed with stitches and mesh is planned later.
Could I wake up with a stoma?
It is uncommon, but possible if a long piece of bowel has died. Most stomas made in this situation are temporary.
How long is the hospital stay after an emergency hernia repair?
Three days to a week is usual. A bowel removal, a wound infection or a stoma can make it considerably longer.
Related pages
The main page on this site is hernia surgery in Ahmedabad. These cover the neighbouring questions.
Where to find us
Dr Harsh Shah, MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
Bring your reports. Second opinions are welcome.