Frequently Asked Questions
It can be daunting to begin your treatment – schedule a consultation with Mr Christian Macutkiewicz to discuss your options, or view the most commonly asked questions below.
Hernia Treatments explained
What causes a hernia?
A hernia is a defect in the abdominal wall that allows tissues (often fat or intestine) to protrude. It can be present at birth or develop later due to factors such as inherited genetics, aging, smoking, chronic coughing, or sustained abdominal pressure.
How do I know if I have a hernia?
People often notice a lump or bulge in the groin or abdomen that may pop out when standing up or coughing and reduce when lying down. Hernias are usually painless or mildly uncomfortable; a lack of swelling or lump makes a hernia less likely but not impossible.
How is a hernia diagnosed?
Most hernias are diagnosed based on history and physical examination. Imaging (such as ultrasound or MRI) may be used when diagnosis is uncertain, but scans can over-diagnose small bulges, so clinical assessment remains key.
Do all hernias require surgery?
Symptomatic hernias (those causing discomfort) should generally be repaired surgically. Asymptomatic or minimally symptomatic male patients may opt for “watchful waiting,” but hernias typically enlarge over time and rarely resolve on their own.
What are the types of hernia surgery?
There are two main approaches: open surgery, which involves a small groin incision and placing a mesh over the defect, and laparoscopic (keyhole) surgery, performed through small abdominal incisions using a camera and instruments. Mesh repair is the standard for both approaches.
How is the decision made between open and laparoscopic repair?
Both methods give similar outcomes when performed by experienced surgeons. Laparoscopic repair may be particularly beneficial for recurrent hernias, bilateral hernias, or hernias in women; open repair under spinal anaesthesia may be preferred for older patients or those unfit for general anaesthesia.
Is mesh necessary in hernia surgery?
Mesh repair is recommended as the first-choice treatment because it lowers recurrence rates compared with simple suturing. International guidelines advise using a flat mesh placed either through an anterior open approach or a laparoscopic (keyhole) technique; plug repairs are discouraged due to higher erosion risk.
What happens on the day of surgery?
Most groin hernia repairs are day‑case procedures. Surgery typically lasts 30–90 minutes, and patients can usually return home the same day if they have support. Preoperative assessment involves checking fitness for surgery, obtaining blood tests, and discussing medications.
What is recovery like?
After surgery, patients are encouraged to mobilise early, take over‑the‑counter analgesics, and eat normally. Bruising and minor numbness are common and subside over time. Most people return to work within 2 weeks (or up to 6 weeks for heavy lifting jobs) and can drive once safely able after two weeks.
What are the risks of hernia surgery?
Complications are rare but can include bleeding, infection, seroma, damage to surrounding structures, bruising, or deep vein thrombosis. Long‑term problems such as recurrence about 1%, chronic discomfort (up to 5 % of repairs) or mesh infection (about 1 in 500) are infrequent.
Does laparoscopic surgery reduce chronic pain?
Evidence suggests laparoscopic (keyhole) techniques offer faster recovery and lower risk of chronic pain compared with open repair; this is why laparoscopy is often recommended for women and bilateral or recurrent hernias.
How long is the recovery after hernia repair?
The most uncomfortable period of recovery is the first two weeks, after this most patients find that bruising, swelling, pain and stiffness reduces weekly. Most patients are fully recovered by 6 weeks
Gallstone Treatments explained
What are gallstones?
Your gallbladder is a small organ below the liver in the upper right abdomen. It’s a pouch that stores bile, a green-yellow liquid that helps with digestion. Most gallstones form when there’s too much cholesterol in the bile.
What is a gallbladder attack?
A gallbladder attack refers to symptoms of gallstones and can often happen after eating a fatty meal.
The most common sign of a gallbladder attack is pain in the upper right abdomen, just under the rib cage. Pain may also be felt in the upper center of the belly, or in the lower chest.
What are the symptoms of gallstones?
Gallstones can lead to pain in the upper right abdomen. You may start to have gallbladder pain from time to time when you eat foods that are high in fat, such as fried foods. The pain doesn’t usually last more than a few hours.
What causes gallstones?
According to Harvard Health Publications, 80 percent of gallstones are made of cholesterol. The other 20 percent of gallstones are made of calcium salts and bilirubin.
It’s not known exactly what causes gallstones to form, though there are some theories.
Too much cholesterol in your bile
Having too much cholesterol in your bile can lead to yellow cholesterol stones. These hard stones may develop if your liver makes more cholesterol than your bile can dissolve.
Too much bilirubin in your bile
Bilirubin is a chemical produced when your liver destroys old red blood cells. Some conditions, such as liver damage and certain blood disorders, cause your liver to produce more bilirubin than it should. Pigment gallstones form when your gallbladder can’t break down the excess bilirubin. These hard stones are often dark brown or black.
Concentrated bile due to a full gallbladder
Your gallbladder needs to empty its bile to be healthy and to function properly. If it fails to empty its bile content, the bile becomes overly concentrated, which causes stones to form.
How are gallstones diagnosed?
Your doctor will perform a physical examination that includes checking your eyes and skin for visible changes in color. A yellowish tint may be a sign of jaundice, the result of too much bilirubin in your body.
The exam may involve using diagnostic tests that help your doctor see inside your body. These tests include:
Ultrasound: An ultrasound produces images of your abdomen. It’s the preferred imaging method to confirm that you have gallstone disease. It can also show abnormalities associated with acute cholecystitis.
Abdominal CT scan: This imaging test takes pictures of your liver and abdominal region.
Gallbladder radionuclide scan: This important scan takes about one hour to complete. A specialist injects a radioactive substance into your veins. The substance travels through your blood to the liver and gallbladder. On a scan, it can reveal evidence to suggest infection or blockage of the bile ducts from stones.
Blood tests: Your doctor may order blood tests that measure the amount of bilirubin in your blood. The tests also help determine how well your liver is functioning.
Endoscopic retrograde cholangiopancreatography (ERCP): ERCP is a procedure that uses a camera and X-rays to look at problems in the bile and pancreatic ducts. It helps your doctor look for gallstones stuck in your bile duct.
Surgery for gallstones
Your doctor may need to perform a laparoscopic gallbladder removal. This is a common surgery that requires general anaesthesia. The surgeon will usually make 3 or 4 incisions in your abdomen. They’ll then insert a small, lighted device into one of the incisions and carefully remove your gallbladder.
You usually go home on the day of the procedure or the day after if you have no complications.
You may experience loose or watery stools after gallbladder removal. Removing a gallbladder involves rerouting the bile from the liver to the small intestine. Bile no longer goes through the gallbladder and it becomes less concentrated. The result is a laxative effect that causes diarrhoea. To treat this, eat a diet lower in fats so that you release less bile.
Are gallstones a serious medical issue?
Gallstones themselves are not usually serious. In some cases people have no symptoms. But in rare cases they can result in serious problems, such as gallbladder infection, inflammation of the pancreas, jaundice, blockage of the bile ducts and liver and tears in the gallbladder, which can be fatal
How do you treat gallstones?
If you have gallstones but no symptoms, you do not need treatment. When needed, choosing a treatment depends on how severe your symptoms are and how large the stones are.
Medications may help break up the gallstones while keeping the gallbladder. Medications are only effective on some types of gallstones, and they can take a long time to work. Shock wave therapy can also be used to help break up the stones while preserving the gallbladder. Stones often recur after using medications or shock wave therapy.
Surgery to remove the gallbladder (cholecystectomy) may be recommended. Gallstones do not come back if the gallbladder is removed. Some people may have more frequent bowel movements following gallbladder removal surgery.
Can pass gallstones on their own?
Small gallstones can sometimes pass on their own.
If stones are small enough, they may exit the gallbladder and pass through the bile ducts, into the intestine, where they are then excreted in your stool.
When gallstones become stuck in the gallbladder or bile ducts they can cause pain, obstructions, and infections.
If gallstones are left untreated, can they cause infection?
If gallstones are not treated, they can get bigger and may lead to complications such as:
Jaundice (yellowing skin and eyes) – if a stone passes out of the gallbladder and into a bile duct, it can block the flow of bile
Acute cholecystitis – when a stone blocks a bile duct, this can lead to a build-up of bile in the gallbladder, which can result in infection and inflammation
Pancreatitis – A gallstone blocks the opening of the pancreas, causing inflammation
Acute cholangitis – When bile ducts become blocked, they can become infected
Will eating a diet high in fibre prevent gallstones?
To help prevent gallstones, eat a high fibre diet including: fruits and vegetables, beans, whole grains and healthy fats (such as fish oil and olive oil). Avoid foods such as fried foods, refined carbohydrates and sugary foods.
What are risk factors for gallstones?
Risk factors for developing gallstones include:
- Certain medications
- Aged over 40
- Family history
- Being female
- Pregnancy
- Taking oestrogen
- Obesity
- High fat or high cholesterol diet
- Rapid weight loss (including patients who have had weight loss surgeries)
- Diabetes
- Fasting often
- Sedentary lifestyle
- Sickle cell disease
- Cirrhosis of the liver
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