Hernia’s and iCare Hernia Repair

A hernia occurs when there is a defect the abdominal wall, most often they are associated with a naturally occurring weakness where vessels, nerves and other structures are passing through the wall into the abdominal cavity. Fat from the abdominal cavity or an organ such as the small intestine can push the thin lining of the abdominal cavity through this weak spot.

Over time the lining that has been pushed through the defect becomes thick forming a sac. The sac contains the fat or organ that originally pushed through the weakness in the muscle. The defect in the abdominal wall is termed the neck of the hernia.

A hernia is usually first noticed as a bulge or lump about the size of a marble that gradually gets larger over time. It can cause discomfort, pain, nausea and effect bowel function.

Groups at increased risk for developing a hernia include:

  • age over 50
  • smokers
  • overweight and obese
  • family history of hernia’s
  • previous abdominal surgery

Weak spots in the abdominal wall can enlarge more rapidly with ongoing pressure and strain, such as:

  • lifting weights
  • lifting on the worksite
  • chronic cough
  • chronic constipation
  • pregnancy
  • enlarged prostate
Incarceration- when the hernia initially develops the fat or organ causing the bulge can move freely in and out of the abdominal cavity. Some hernia’s will appear as an intermittent bulge that can be easily pushed back into the abdominal cavity, other more chronic hernia’s can be partially pushed back in’or not pushed back in at all. When this occurs, it is termed an incarcerated hernia.

Obstruction- if bowel is trapped within the hernia sac it may become blocked due to twisting, obstructions may be partial or complete. A bowel obstruction is a surgical emergency, it is important to have your hernia repaired at a much earlier stage not only to avoid this but also early repair reduces risk of the hernia recurring in the future.

Strangulation- when the blood supply to trapped bowel or fat within the hernia sac is cut off, often due to kinking at the level of the hernial defect. Strangulation is also a surgical emergency as it means that the organ trapped is dying and may need to be removed.
If you have developed a hernia at work, after notifying your employer you will be asked to see a GP who will examine you and then refer you to Dr Boccola for further assessment, you will likely be asked to complete an ultrasound or CT scan before the appointment. Your employer will need to notify icare or their current claims service provider within 48hours. If Dr Boccola recommends a surgical hernia repair then he will provide you with a Certificate of Capacity outlining your treatment and return to work plan. icare will need to approve this prior to surgery and that can often take 2-3 weeks. icare may contact yourself, your employer and your treating doctors to determine how best to support your recovery.

In 2015 WorkCover NSW was replaced by iCare. Insurance and Care NSW (iCare) was created as a new organization to deliver insurance and care schemes in NSW. It delivers insurance and care services under the NSW Workers Compensation Scheme and is the largest general insurance service provider in Australia. In NSW injuries covered by workers compensation are now managed under iCare, the organisation has a comprehensive website at icare.nsw.gov.au where more information regarding the lodgement process can be found.

Dr Boccola will prescribe a return to work management plan often involving 2 weeks at home to recover from your operation with a gradual return to work involving restricted hours and modified duties with no heavy lifting. If your workplace can not accommodate a reasonable return to work plan it is better to spend the required time at home, until you are able to return to full duties, this may be 4-6 weeks in some cases. Dr Boccola will keep in close contact with you throughout your recovery period to modify the plan as required.

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