Groin Hernia

Patients recovering from groin hernia must do not put the tissues under tension after a week of repairs, so they are advised not to drive for a month or two. From this point of view during a sudden impact or stop the postoperative pain could prolong reaction times.

In the major cities around the globe preclusion for driving can have socioeconomic consequences. The social and psychological recovery, beside the patients’ physical wellbeing improve the hernia repair.

Mechanical and chemical stimulation of large, myelinated nerve fibres (A-alpha fibres) or small, unmyelinated nerve fibres (C fibres) cause the pain that follows the repair of hernias in the groin. The pain can be caused by mechanical stimulation of somatic tissues when the tension is created on the fibroconnective tissue of the groin directly and indirectly.

Directly pain appears through mechanical stimulation of A-alfa and C fibres and indirectly through the release of chemical substances that further stimulate the C fibres. Hydrogen, potassium, bradykinin, serotonin, histamine, acetylcholine, proteolytic enzymes and prostaglandins are chemical substances. Stimulation by chemical substances of C fibres that innervate the hernia sac that is excised and ligated during the traditional repair cause visceral pain.

Undue tension on the suture line which leads to somatic pain through C and A-alfa nerve fibres is associated with forceful approximation of the fibroconnective tissues of the groin,the traditional method of hernia repair. Visceral pain resulted by the ligation of the hernia sac are caused by mechanical stimulation and ischaemic changes in the peritoneum that lead to the release of chemical substances. A layer of synthetic mesh are used in modern hernia repairs to avoid tissues under tension. These repairs because they eliminate the somatic component of the pain are associated with a reduction in postoperative pain and in the visceral component of the post-herniorrhaphy pain appear a reduction because the hernia sac is not ligated.

Because the healing of hernia take between six and eight weeks it’s better that patients do not drive in this time. The intra-abdominal pressure can increase because of the inertial force of an impact or sudden stop which can disrupt the suture line of the repair. Because the technique does not involve pulling together and suturing the edges of the defect hernia repairs which do not use tissue tension are not at risk for this. From the postoperative discomfort which is minimal and without narcotic analgesics the recovery period depends. The open repair without tension and laparoscopic repair are equally associated with decreased postoperative pain. From this point of view have been done comparisons between laparoscopic hernia repair and tissue approximation under tension and open repair carried out without tissue tension.

Different types of hernia repairs carried out without tissue tension can be associated with the reduction in postoperative pain and the risk of recurrence which can allow to patients to have normal daily activities, including driving. At one week or less after the surgery depending on their comfort and the narcotic analgesics used patients can drive. The pattern of convalescence after the surgery have been changed through modern techniques of hernia repair.

From different types of vehicles patients need different advises, but it is better for them that after the surgery to rest a month or two before driving.

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