Consultant surgeon



Is gauze or mesh being used to fix hernias?

Mesh is now used to repair virtually all hernias. Using stitches alone is rarely adequate as tension across the repair increases the risk of recurrence. A variety of sizes, shapes and materials can be used to repair hernias in a tension-free manner. The choice of material may be less important than how and where it is used but certain circumstances (e.g. risk of infection) call for the use of specific materials. All implants become incorporated into your own tissues in time.

Is a keyhole repair better?

There is no doubt that endoscopic techniques lead to less pain and a shorter recovery period. There may also be fewer complications overall. In the case of inguinal hernias, there appears to be an advantage in using endoscopic techniques to repair recurrent or bilateral hernias. For unilateral inguinal hernias, I would help you to choose the method of repair after full discussion of the pros and cons of both open and "keyhole" methods.

Will I be asleep for my operation or can I have local anaesthetic?

For most people, a general anaesthetic to repair a hernia causes no problems. I am more than happy to provide local anaesthetic repairs for primary groin and abdominal wall hernias. A general anaesthetic is required if laparoscopic repair is desired.

How quickly will I be back to doing the things I normally do?

This will depend upon the type and size of hernia being repaired, the recommended method of repair and your level of fitness. Therefore it can vary from a few days for keyhole repairs of simple groin hernias to several weeks for large, complex, recurrent abdominal wall hernias. I will be able to give you an estimate as to how long you need to be off work as well as a programme of graduated exercise to bring you back to former fitness.

Bowel cancer

Will I be cured?

You are more likely to be cured if bowel cancer is picked up in its early stages. Although we may have some idea of this before treatment, when there is no sign of cancer spread it is only after the cancer has been surgically removed that a pathologist can examine it and accurately determine the stage it has reached.

Will I have to have a bag?

Usually no. Most bowel operations lead to a rejoining of the bowel at the time. However, some operations mandate the formation of a stoma (ileostomy or colostomy) at the time but in a lot of cases this will be reversible at a later stage. You will know before your operation if this is likely.

Will I need chemotherapy or radiotherapy?

Not necessarily. Anti-cancer drug treatment is reserved for the minority who have inoperable tumours or for those people whose cancers, once removed, are found to be at a stage where future recurrence is likely.

In the main, radiotherapy is confined to cancers of the rectum (the first 15cm in from the anus) and is given before surgery to reduce the risk of recurrence.

What checks will I need in the future?

There are a number of reasons for future follow up. Most importantly, this involves detecting potential recurrence at an early stage. This is done by CT scanning. Treatment is likely to be more effective if recurrence is detected before it causes symptoms. Further colonoscopy ensures the remaining bowel stays healthy.

Is bowel cancer inherited?

In the majority of cases, no. Bowel cancer is common and it's not unusual to have somebody in your family who has had it. The development of cancer is only partially understood but is a complex interaction involving our genes and environment. If it was felt that there was an inherited predisposition in your family, I would discuss with you a referral to a genetics advisor.

What can I do to prevent bowel cancer?

This is Medicine's Holy Grail and, at some time in the future, cancer will be fully understood to the point that it can be prevented. At present, however, there may be actions you can take to reduce your risk. The simplest and least controversial things to do are not to gain excessive weight and give up (certainly don't start) smoking. If you have any persisting bowel symptoms, report them to your doctor.

If you have no symptoms, make sure you take up any screening that is offered or ask if you can access this yourself.

Taking an aspirin a day may help but, as this is not without potential side effects, it is best to discuss with your doctor first.

Screening for bowel cancer

Frequent questions about the process.