Home in five hours after a hernia operation

Case study

NICHOLAS TIMMINS

Hernias - despite the jokes they bring about middle-aged men and trusses - can happen at any age, and one happened to Robert Pinckney, 20, a student at Roehampton Institute in south-west London, last February.

The bulge in his groin was not painful, but it was unsightly. And for someone who plays enthusiastic badminton two or three times a week it plainly had to be sorted out.

A visit to his GP brought a hospital appointment a few weeks later and confirmation that an operation was needed. Mr Pinckney, a history and English student, put the operation off until the summer holidays for fear that if it was done in term-time it might hamper his degree work.

"I was told that would be all right and I was worried the operation would knock me back a bit and affect my course," he said.

Operation day took him to the new, dedicated day-case surgery centre at Kingston hospital, where he was offered the choice of a general or a local anaesthetic.

"I'm a bit of a coward," he said, "so I took the general. I didn't really want to watch it happening." In at 9am, he was scheduled towards the end of the morning's operating list, so a couple of hours reading magazines was followed by the trip down to the theatre, the anaesthetic and the operation.

He was home with his parents by 2pm - complete with an information pack about what he should and should not do, which backed up a leaflet and information he had been given at his original consultation where the day- case procedure had been explained to him.

"The first day I was told to stay in bed, but on the second I had to go for a short walk each hour - just down the landing - and then back to bed. The third day it was downstairs, sitting in a straight-backed chair and then just gradually doing more. It was quite slow progress at first because I was doubled up a bit. But once I'd managed to straighten up, by the end of the first week, it was then very rapid.

"Within 10 days I was doing really well." At no point, he said, was it an agonising experience. "Obviously it hurt at first when I moved, but you had to do some of that to get back to normal. It was very uncomfortable, but not that painful."

He went back to hospital after a few weeks for a quick check that all was well. But with modern wound-closing techniques, there were not even any stitches to take out. "I'd been told not to lift anything for a few weeks and not to play football or anything like that for 10 weeks or so. They told me then I'd have to do something quite drastic to do any damage, but still to avoid anything too strenuous for the next few weeks. It's just fine now."

The experience has left him a fan of day-case surgery. "I'd much prefer to be at home in familiar surroundings and with the family than be in hospital. And I think it's psychologically good. Helps you get back to normal as quickly as possible. If it ever happened again ... I'd do it as a day case again."

Before day-case surgery, Mr Pinckney might have had six to eight days in hospital - and an acute NHS bed costs hundreds of pounds a night. "I'll admit I wasn't looking forward to it. I don't think you look forward even to a minor operation. But from my point of view, it went really well," he said.