the gilmore groin & hernia clinic - 108 harley street · t: + 44 (0)20 7563 1234 f: + 44 (0)20...

T: + 44 (0)20 7563 1234 F: + 44 (0)20 7563 1212

E: [email protected] W: www.108harleystreet.co.uk

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T: + 44 (0)20 7563 1234

F: + 44 (0)20 7563 1212

E: [email protected]

www.108harleystreet.co.uk

THE GILMORE GROIN & HERNIA CLINIC

MEDICALCHAMBERS 108 HARLEY STREET LONDON WIG 7ET

T: + 44 (0)20 7563 1234 F: + 44 (0)20 7563 1212


T H EG I L M O R E G R O I N &H E R N I AC L I N I C

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ABOUT US In 1991 The Gilmore Groin and Hernia Clinic was established at 108 Harley Street and provides the highest professional standards of assessment, diagnosis and treatment for patients with groin disruption (Gilmore’s Groin) and herniae of all types within a friendly and reassuring environment.

All treatment and rehabilitation programmes are individually tailored to suit your needs by members of our experienced specialist team working closely together to ensure ultimate peace of mind and minimum delays.

THE GILMORE GROIN & HERNIA CLINICI ABOUT US


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OUR APPROACH

People visit The Gilmore Groin and Hernia Clinic, at 108, Harley Street, for a variety of reasons, most commonly they have been referred by a medical practitioner because either they have groin pain which has not responded to physiotherapy and treatment or a hernia has been diagnosed and a repair is required.

The clinic is dedicated to minimising patient anxiety. Our caring, highly experienced, multi-disciplinary professional team is available every weekday, so appointments can be usually be offered within 24 hours sometimes even the same day.

The Consultant Surgeon led team offers the best possible assessment of these conditions in the shortest possible time all on one site.

Consultant clinics are held daily in our relaxed and friendly premises and are designed to lead to a rapid yet accurate diagnosis. Following expert physical examination the onsite X-Ray and Imaging Centre offers facilities for general x-ray and ultrasound imaging as required. MRI scanning, if indicated can be undertaken at partner facilities.

Once diagnosis has been confi rmed appropriate treatment can be recommended. This appropriate treatment is discussed and agreed with the patient, it can be either surgical intervention or the ongoing management of the condition.


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We provide a comprehensive rapid access diagnostic and assessment service:

• Consultant Surgeon led specialist team

• Daily Consultant clinics

• On-site general xray

• On-site ultrasound

• Rapid results

• Experienced Nurses

• Fast Access to Surgery

ACCREDITATIONS

FACILITIES AND SERVICES

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We provide a comprehensive rapid access diagnostic and assessment service:

• Consultant Surgeon led specialist team

• Daily Consultant clinics

• On-site general xray

• On-site ultrasound

• Rapid results

• Experienced Nurses

• Fast Access to Surgery

ACCREDITATIONS

FACILITIES AND SERVICES

THE

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Advice and InformationAll our practice nurses have undergone specialist training. To ensure continuity of care and a full understanding of your situation, they are available for pre and post operative information, advice and support, for both out-patients and in-patients on all aspects of groin and hernia surgery.

AssessmentThe clinic is structured for the rapid assessment of Gilmore’s Groin groin disruption syndrome and herniae of all types.

RehabilitationThere is an established rehabilitation programme for Gilmore’s Groin, which may be recommended to try and avoid the need for surgery as well for use post operatively where surgery is required. A post operative rehabilitation programme is also available for hernia surgery.

SurgeryIn patient admission for surgical repair of the condition under general anaesthetic.

THE GILMORE GROIN & HERNIA CLINIC


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T: + 44 (0)20 7563 1234 F: + 44 (0)20 7563 1212E: [email protected] W: www.108harleystreet.co.uk

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THE TEAM I CONSULTANTS


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CONSULTANT SURGEONMr O J A Gilmore MS FRCS FRCS (ED)Jerry Gilmore qualifi ed at St Bartholomews Hospital in London, obtaining the Begley Prize from the Royal College of Surgeons of England.

In 1975, he was awarded the Moynihan Prize by the Association of Surgeons of Great Britain, and the Hamilton Bailey Prize by the International College of Surgeons. In 1976, he was awarded a Master of Surgery Degree by the University of London and appointed Hunterian Professor by the Royal College of Surgeons of England. Appointed Consultant Surgeon to St Bartholomews Hospital, where he established the Breast Unit in 1981. Appointed Surgical Assessor to the National Breast Screening Programme in 1988.

He established the clinic at 108 Harley Street in 1991 in order to offer private patients the multidisciplinary approach used in the NHS Breast Screening Programme.

CONSULTANT SURGEONMr Simon Marsh MA MD FRCSSimon Marsh trained at Trinity College Cambridge and the Clinical School, Addenbrookes Hospital.

He was one of the few students to be awarded the William Harvey Studentship in consecutive years. His MD thesis, from the University of Cambridge focused on the role of growth factors in breast cancer. He is Senior Consultant Surgeon in the Colchester Breast Unit in Essex and has been a member of The London Breast Clinic since 1999. In 2006 he halved his workload within the NHS to dedicate more time to The London Breast Clinic. He retains an active interest in cancer research and is an Honorary Senior Lecturer to the Department of Biomedical Sciences in the University of Essex.

Simon is also Surgical Director of the Ivry Street Minor Surgical Unit in Ipswich that annually undertakes in excess 1,000 cases pa.

The team comprises Consultants, Dermatologists, Cytologists & Histopathologists , Oncologists and Nurses. They provide a high quality service to the patients and their referrers. In addition to the routine day to day team working there are regular meetings which cover clinical, best practice and educational updates and reviews as well as detailed case audit.



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The team comprises Consultants, Dermatologists, Cytologists & Histopathologists , Oncologists and Nurses. They provide a high quality service to the patients and their referrers. In addition to the routine day to day team working there are regular meetings which cover clinical, best practice and educational updates and reviews as well as detailed case audit. AT

CONSULTANT SURGEON

Mr Simon Marsh MA MD FRCS Eng FRCS (Gen Surg) Simon Marsh trained at Trinity College Cambridge and the Clinical School, Addenbrookes Hospital. He was one of the few students to be awarded the William Harvey Studentship in consecutive years.

He qualifi ed in 1987, having been awarded a BA in 1985. In 1992 he was made a Fellow of the Royal College of Surgeons in England and granted an MA from Cambridge.

In 1996 he was awarded an MD by the University of Cambridge and received the Intercollegiate Fellowship in General Surgery.

In 1999 having been appointed as Consultant surgeon in Colchester he joined the team at 108 Harley Street. In 2006 he halved his workload within the NHS to dedicate more time to work here.

Following qualifi cation he developed an interest in sports medicine and has advised on many sports, including equestrian events, motorcycle speedway and rugby. This expertise has ensured his success since joining The Gilmore Groin and Hernia Clinic where he has become adept and experienced in assessing,

diagnosing and treating patients not only with hernia of all types but also with Gilmore’s Groin.

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THE SURGICAL TEAM I CONSULTANTS

CONSULTANT SURGEONMr Simon Marsh MA MD FRCS Eng FRCS (Gen Surg)

Simon Marsh trained at Trinity College Cambridge and the Clinical School, Addenbrookes Hospital. He was one of the few students to be awarded the William Harvey Studentship in consecutive years.




Following qualifi cation he developed an interest in sports medicine and has advised on many sports, including equestrian events, motorcycle speedway and rugby. This expertise has ensured his success since joining The Gilmore Groin and Hernia Clinic where he has become adept and experienced in assessing, diagnosing and treating patients not only with hernia of all types but also with Gilmore’s Groin.


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CONSULTANT SURGEON Mr Gordon Buchanan MD MSc FRCS (Gen)Gordon is Consultant Colorectal and General Surgeon at Charing Cross and Hammersmith Hospitals, London. He carries out a wide variety of Colorectal and General Surgical procedures.

He graduated from St Thomas’ Hospital, London and undertook colorectal and general surgical training in South East England. He also received advanced colorectal training at St Mark’s Hospital, Harrow, St Thomas’ Hospital, London and Mount Sinai Hospital, Toronto, Canada.

CONSULTANT SURGEON Mr Emin Carapeti MBBS MD FRCS (Gen)Emin is Consultant General and Colorectal Surgeon at Guy’s and St Thomas’ Hospitals. He qualifi ed at Guy’s Hospital and undertook his training in London and the south east.

Advanced colorectal training was undertaken at St Mark’s Hospital Harrow and Mount Sinai Toronto Canada.His special interests are the management of haemorrhoids and pilonidal sinus disease and he is a specialist in the surgical treatment of complex Crohn’s disease and ulcerative colitis.

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THE SURGICAL TEAM I CONSULTANTS

CONSULTANT SURGEONMr Simon Marsh MA MD FRCS Eng FRCS (Gen Surg)

Simon Marsh trained at Trinity College Cambridge and the Clinical School, Addenbrookes Hospital. He was one of the few students to be awarded the William Harvey Studentship in consecutive years.




Following qualifi cation he developed an interest in sports medicine and has advised on many sports, including equestrian events, motorcycle speedway and rugby. This expertise has ensured his success since joining The Gilmore Groin and Hernia Clinic where he has become adept and experienced in assessing, diagnosing and treating patients not only with hernia of all types but also with Gilmore’s Groin.

CONSULTANT SURGEON

Mr Gordon Buchanan MD MSc FRCS (Gen) Gordon Buchanan is Consultant Colorectal and General Surgeon at Imperial College Healthcare NHS Trust, London. He is experienced in carrying out a wide variety of Colorectal and General Surgical procedures. He undertakes laparoscopic hernia repair as a member of The Groin and Hernia Clinic team.

He graduated from St. Thomas’ Hospital, London and undertook colorectal and general surgical training in South East England. He also received advanced colorectal training at St. Mark’s Hospital, Harrow, St. Thomas’ Hospital, London and Mount Sinai Hospital, Toronto, Canada.

During additional laparoscopic colorectal training fellowships, in Colchester and Yeovil, Gordon Buchanan undertook laparoscopic appendicectomy and day case laparoscopic cholecystectomy, as well as benign and malignant laparoscopic colorectal resection. He also undertook research at St. Mark’s Hospital and Imperial College, London. He has published papers on many aspects of colorectal surgery, in particular investigation of anorectal conditions and fistula-in-ano. He is presently undertaking collaborative research on laparoscopic resection of colorectal cancer.

CONSULTANT SURGEON

Mr Emin Carapeti MBBS MD FRCS (Gen) Emin is Consultant General and Colorectal Surgeon at Guy’s and St Thomas’ Hospitals. He qualifi ed at Guy’s Hospital and undertook his training in London and the south east.

Advanced colorectal training was undertaken at St Mark’s Hospital Harrow and Mount Sinai Toronto Canada. His special interests are the management of haemorrhoids and pilonidal sinus disease and he is a specialist in the surgical treatment of complex Crohn’s disease and ulcerative colitis.


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On your fi rst visit to the clinic, you will be greeted by a receptionist, who will collect any referral letters, x-rays, test results or other information you have brought with you. These will be passed to the consultant surgeon. It is helpful if you can arrive at least 15 minutes prior to your appointment time so that the consultant surgeon has time to review the information prior to your consultation and any outstanding personal information can be obtained.

You can then take a seat in the waiting room, where a medical secretary may see you if any personal information is still required. A nurse will then take you to meet the consultant surgeon. A spouse, partner, relative or friend can accompany you, or the nurse can stay with you during your consultation and examination.

Initial ConsultationWhether you have referred yourself, or been referred because of concern about a groin pain or a hernia, the consultant surgeon will discuss the nature of your problem and any other relevant information, such as your general medical history and family history. A thorough examination will follow. The nurse can be present during this examination.

The consultant will then discuss your care, and may request investigations to exclude other underlying conditions, such as stork view, and/or ultrasound. Normally these investigations will have been booked when you made your initial appointment. If they are required, you will be given the relevant forms to present to the onsite X-Ray and Imaging Unit.

If rehabilitation is recommended to try an avoid surgery you will be given a copy of the programme and a date for re-assessment is set.

If surgery is indicated the proposed operation will be explained All our patient care is based on informed consent, you will not be asked to agree to further or alternative procedures. You will always know exactly what operation you will be undergoing before admission to hospital. Surgery can be arranged at this time for a mutually convenient date and confi rmed upon pre-authorisation by medical insurers, where relevant.

The consultant surgeon will then write to your GP and any other referring doctor, with copies to you (if requested) and other relevant specialists, summarising your consultation and the planned investigations. Letters are also sent after all subsequent consultations or when the results of investigations become available.

WHAT TO EXPECT

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On your fi rst visit to the clinic, you will be greeted by a receptionist, who will collect any referral letters, x-rays, test results or other information you have brought with you. These will be passed to the consultant surgeon. It is helpful if you can arrive at least 15 minutes prior to your appointment time so that the consultant surgeon has time to review the information prior to your consultation and any outstanding personal information can be obtained.

You can then take a seat in the waiting room, where a medical secretary may see you if any personal information is still required. A nurse will then take you to meet the consultant surgeon. A spouse, partner, relative or friend can accompany you, or the nurse can stay with you during your consultation and examination.

Initial ConsultationWhether you have referred yourself, or been referred because of concern about a groin pain or a hernia, the consultant surgeon will discuss the nature of your problem and any other relevant information, such as your general medical history and family history. A thorough examination will follow. The nurse can be present during this examination.

The consultant will then discuss your care, and may request investigations to exclude other underlying conditions, such as stork view, and/or ultrasound. Normally these investigations will have been booked when you made your initial appointment. If they are required, you will be given the relevant forms to present to the onsite X-Ray and Imaging Unit.

If rehabilitation is recommended to try an avoid surgery you will be given a copy of the programme and a date for re-assessment is set.

If surgery is indicated the proposed operation will be explained All our patient care is based on informed consent, you will not be asked to agree to further or alternative procedures. You will always know exactly what operation you will be undergoing before admission to hospital. Surgery can be arranged at this time for a mutually convenient date and confi rmed upon pre-authorisation by medical insurers, where relevant.

The consultant surgeon will then write to your GP and any other referring doctor, with copies to you (if requested) and other relevant specialists, summarising your consultation and the planned investigations. Letters are also sent after all subsequent consultations or when the results of investigations become available.

WHAT TO EXPECT


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Follow Up AppointmentIf a rehabilitation programme has been recommended then further assessment of the condition will take place. The consultant surgeon will discuss with you the results of the investigations carried out. He will recommend appropriate treatment and you will have the opportunity to ask questions and discuss the benefi ts and any contra-indications of the treatment proposed.

If surgery is indicated, the proposed operation will be explained. All our patient care is based on informed consent, you will not be asked to agree to further or alternative procedures. You will always know exactly what operation you will be undergoing before admission to hospital.

If surgery is not required then you will be discharged back to your GP and other referring specialists but are able to return should the problems recur.

All patients are followed up, as required, following surgery to ensure that the repair is intact and they will be given guidance on return to activities.

SurgeryIf an operation is required it can be arranged immediately for the fi rst mutually convenient date for you and your surgeon. Surgery under general anaesthetic takes place at a partner hospital and The Gilmore Groin and Hernia Clinic staff will make the booking for you. The partner hospital is recognised by all medical insurance companies but it is important that you confi rm with your insurers that it is listed on those covered by your policy. Each patient is given a full estimate of the professional fees for the surgery and also an indication of length of inpatient stay required.

The patient will be admitted to the hospital on the morning of the operation. On admission, a hospital administrator will ask for contact information and confi rm your method of payment (insurance details etc.) Once admitted to their room a nurse will confi rm the patient’s personal details, answer any questions concerning hospital procedures and attach to the patients wrist a bracelet with their name and hospital number. Any further investigations, such as blood tests or x-rays requested by the patient’s consultant surgeon will be undertaken. The consultant surgeon will visit both before and ask the patient to sign a consent form for the operation and again after the operation. The consultant anaesthetist will also make a pre-operative visit to ask relevant questions and explain the method of anaesthesia and will also visit again post-operatively.

WHAT TO EXPECT

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Follow Up AppointmentIf a rehabilitation programme has been recommended then further assessment of the condition will take place. The consultant surgeon will discuss with you the results of the investigations carried out. He will recommend appropriate treatment and you will have the opportunity to ask questions and discuss the benefi ts and any contra-indications of the treatment proposed.

If surgery is indicated, the proposed operation will be explained. All our patient care is based on informed consent, you will not be asked to agree to further or alternative procedures. You will always know exactly what operation you will be undergoing before admission to hospital.

If surgery is not required then you will be discharged back to your GP and other referring specialists but are able to return should the problems recur.

All patients are followed up, as required, following surgery to ensure that the repair is intact and they will be given guidance on return to activities.

SurgeryIf an operation is required it can be arranged immediately for the fi rst mutually convenient date for you and your surgeon. Surgery under general anaesthetic takes place at a partner hospital and The Gilmore Groin and Hernia Clinic staff will make the booking for you. The partner hospital is recognised by all medical insurance companies but it is important that you confi rm with your insurers that it is listed on those covered by your policy. Each patient is given a full estimate of the professional fees for the surgery and also an indication of length of inpatient stay required.

The patient will be admitted to the hospital on the morning of the operation. On admission, a hospital administrator will ask for contact information and confi rm your method of payment (insurance details etc.) Once admitted to their room a nurse will confi rm the patient’s personal details, answer any questions concerning hospital procedures and attach to the patients wrist a bracelet with their name and hospital number. Any further investigations, such as blood tests or x-rays requested by the patient’s consultant surgeon will be undertaken. The consultant surgeon will visit both before and ask the patient to sign a consent form for the operation and again after the operation. The consultant anaesthetist will also make a pre-operative visit to ask relevant questions and explain the method of anaesthesia and will also visit again post-operatively.

WHAT TO EXPECT


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GILMORE’S GROIN (GROIN DISRUPTION)I SYMPTOMS

Gilmore’s Groin (Groin Disruption)The syndrome was fi rst recognised in 1980, following the successful treatment of three professional footballers who had been unable to play for many months because of undiagnosed injuries of the groin. Although some people refer to it as a Sportmen’s Hernia there is no true hernia present. Groin disruption (Gilmore’s Groin) is a severe musculo-tendinous injury of the groin, which can be successfully treated by the surgical restoration of normal anatomy.

PathologyThe pathology of groin disruption found at operation is varied, however, the main features include:

• torn external oblique aponeurosis • torn conjoined tendon • conjoined tendon torn from pubic tubercle • dehiscence between conjoined tendon and inguinal ligament

Between 1980 and 2007 over 7,000 cases have been referred for assessment and treatment

SymptomsThe symptoms are pain in the groin increased by running, sprinting, twisting and turning, and kicking. After sport, the patient is stiff and sore. The day after a game, turning or getting out of bed or a car often causes pain, as may coughing, sneezing and sit-ups.

There is a history of specifi c injury in only 30% of patients – usually overstretching, abduction and eversion injuries. Symptoms usually indicate it is an overuse (wear and tear) injury.

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GILMORE’S GROIN (GROIN DISRUPTION)I SYMPTOMS

Gilmore’s Groin (Groin Disruption)The syndrome was fi rst recognised in 1980, following the successful treatment of three professional footballers who had been unable to play for many months because of undiagnosed injuries of the groin. Although some people refer to it as a Sportmen’s Hernia there is no true hernia present. Groin disruption (Gilmore’s Groin) is a severe musculo-tendinous injury of the groin, which can be successfully treated by the surgical restoration of normal anatomy.

PathologyThe pathology of groin disruption found at operation is varied, however, the main features include:

• torn external oblique aponeurosis • torn conjoined tendon • conjoined tendon torn from pubic tubercle • dehiscence between conjoined tendon and inguinal ligament

Between 1980 and 2007 over 7,000 cases have been referred for assessment and treatment

SymptomsThe symptoms are pain in the groin increased by running, sprinting, twisting and turning, and kicking. After sport, the patient is stiff and sore. The day after a game, turning or getting out of bed or a car often causes pain, as may coughing, sneezing and sit-ups.

There is a history of specifi c injury in only 30% of patients – usually overstretching, abduction and eversion injuries. Symptoms usually indicate it is an overuse (wear and tear) injury.


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GILMORE’S GROIN I DIAGNOSIS I INVESTIGATIONSI TREATMENT I ADMISSION

DiagnosisGroin disruption is a clinical diagnosis based on history and examination. Inverting the scrotum and placing the examining little fi nger in each superfi cial inguinal ring in turn gives the diagnosis.

On the affected side the ring is usually dilated, there is a cough impulse and most importantly there is tenderness. Adductor weakness is present in 40%, this sometimes also requires surgical treatment.

InvestigationsStork or fl amingo x-ray views of the pelvis are taken to exclude pelvic instability, osteitis pubis and hip problems. Movement of the symphysis should be less than 3mm. M.R.I. scan is required in some patients with confl icting symptoms and physical signs.

Adductor Injury40% of patients diagnosed with Gilmore’s Groin also have torn adductors. Minor and moderate tears usually respond to adductor exercises and physiotherapy. Patients with severe adductor tears usually require adductor tenotomy or release.

TreatmentThe success of surgery for groin disruption (Gilmore’s Groin) depends on accurate diagnosis, meticulous repair of each element of the disruption and intensive rehabilitation according to a standard rehabilitation programme. Surgery is indicated in sportsmen, who are unable to play, or fail to respond to rehabilitation.

The surgical treatment consists of restoring normal anatomy with a six-layered structural repair of the inguinal region. Adductor tenotomy is indicated in patients with persistent and troublesome adductor tears, which do not respond to conservative treatment.

AdmissionPatients are admitted on the day of operation and return home after physiotherapy, usually within 24 hours. The standard rehabilitation programme is then followed.

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GILMORE’S GROIN I DIAGNOSIS I INVESTIGATIONSI TREATMENT I ADMISSION

DiagnosisGroin disruption is a clinical diagnosis based on history and examination. Inverting the scrotum and placing the examining little fi nger in each superfi cial inguinal ring in turn gives the diagnosis.

On the affected side the ring is usually dilated, there is a cough impulse and most importantly there is tenderness. Adductor weakness is present in 40%, this sometimes also requires surgical treatment.

InvestigationsStork or fl amingo x-ray views of the pelvis are taken to exclude pelvic instability, osteitis pubis and hip problems. Movement of the symphysis should be less than 3mm. M.R.I. scan is required in some patients with confl icting symptoms and physical signs.

Adductor Injury40% of patients diagnosed with Gilmore’s Groin also have torn adductors. Minor and moderate tears usually respond to adductor exercises and physiotherapy. Patients with severe adductor tears usually require adductor tenotomy or release.

TreatmentThe success of surgery for groin disruption (Gilmore’s Groin) depends on accurate diagnosis, meticulous repair of each element of the disruption and intensive rehabilitation according to a standard rehabilitation programme. Surgery is indicated in sportsmen, who are unable to play, or fail to respond to rehabilitation.

The surgical treatment consists of restoring normal anatomy with a six-layered structural repair of the inguinal region. Adductor tenotomy is indicated in patients with persistent and troublesome adductor tears, which do not respond to conservative treatment.



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GILMORE’S GROINI REHABILITATION PROGRAMMEI RESULTS

Gilmore’s Groin Rehabilitation ProgrammeWhen doing the exercises it is important to activate the “core stability” muscles. These muscles consist of the stabilising abdominal muscles and some of the lower back muscles. The hospital physiotherapist will show you how to do this and the Practice Nurses are available for advice if you have any concerns.

Week 1 First day after operation: Essential to stand upright and walk 20 mins. Thereafter walk gently 4 times a day. Gentle stretching and core stability exercises given by physiotherapist to be followed

Week 2 Jogging and gentle running in straight lines. Gentle sit-ups with knees bent.Adductor exercises. Step ups

Week 3 Increase speed to sprinting. Increase sit-ups and adductor exercises. Cycling. Swimming (crawl)

Week 4 Sprint. Twist & Turn. Kick. Play

If required rehabilitation can be supervised at our sports rehabilitation centre at The Island Clinic, Hook, Hampshire RG27 9EH. Email: [email protected] or Tel: 01256 769344

NOTE • While exercising, and afterwards, some discomfort will be experienced at the repair and adductor insertion site.

• Provided you adhere to the programme and avoid sudden sharp movements, you will suffer no harm.

• Stiffness and discomfort occur the day after vigorous exercises. For this reason, some form of exercise is advised 7 days a week.

• Swelling at the operation site takes 8 to 12 weeks to clear completely.

ResultsBetween 1980 and 2007 over 7,000 cases have been referred. Of those 4,100 required an operation, usually returning to full sporting activities within 4-6 weeks.

Research has shown surgery to be successful in 97% of professional soccer players. The condition is most frequent in association footballers (58% of referrals).

85 English football league clubs have referred players, whilst many came from Ireland, Scotland, Wales, Europe and other continents. Other sports include Rugby Union and League (10%), racquet games (4%), athletics (4%), cricket (2%), hockey (2%), and those undertaking general fi tness training and other sports (20%).

Over the past 27 years, the operation has been successfully performed on over 370 international sportsmen and women.

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GILMORE’S GROINI REHABILITATION PROGRAMMEI RESULTS

Gilmore’s Groin Rehabilitation ProgrammeWhen doing the exercises it is important to activate the “core stability” muscles. These muscles consist of the stabilising abdominal muscles and some of the lower back muscles. The hospital physiotherapist will show you how to do this and the Practice Nurses are available for advice if you have any concerns.

Week 1 First day after operation: Essential to stand upright and walk 20 mins. Thereafter walk gently 4 times a day. Gentle stretching and core stability exercises given by physiotherapist to be followed

Week 2 Jogging and gentle running in straight lines. Gentle sit-ups with knees bent.Adductor exercises. Step ups

Week 3 Increase speed to sprinting. Increase sit-ups and adductor exercises. Cycling. Swimming (crawl)

Week 4 Sprint. Twist & Turn. Kick. Play


NOTE • While exercising, and afterwards, some discomfort will be experienced at the repair and adductor insertion site.



• Swelling at the operation site takes 8 to 12 weeks to clear completely.

ResultsBetween 1980 and 2007 over 7,000 cases have been referred. Of those 4,100 required an operation, usually returning to full sporting activities within 4-6 weeks.

Research has shown surgery to be successful in 97% of professional soccer players. The condition is most frequent in association footballers (58% of referrals).

85 English football league clubs have referred players, whilst many came from Ireland, Scotland, Wales, Europe and other continents. Other sports include Rugby Union and League (10%), racquet games (4%), athletics (4%), cricket (2%), hockey (2%), and those undertaking general fi tness training and other sports (20%).

Over the past 27 years, the operation has been successfully performed on over 370 international sportsmen and women.


T: + 44 (0)20 7563 1234 F: + 44 (0)20 7563 1212



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T: + 44 (0)20 7563 1234 F: + 44 (0)20 7563 1212



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HERNIA I TYPES

HerniaA hernia is a protrusion of a viscus (an organ) beyond its normal confi nes and occurs in either the groin or the abdomen. This protrusion produces a swelling; if it clears on lying down, it is known as a reducible hernia, or if it fails to clear an irreducible hernia. Hernias can be painless, cause slight discomfort or be painful. They tend to get larger with time and can make it diffi cult to undertake normal activities.

Although hernias in adults can arise for a number of reasons some common examples are:

• persistent heavy coughing, • injury or surgery, • lifting, carrying or pushing heavy loads • straining to produce a bowel movements • straining to urinate e.g. men who have an enlarged prostate. • Being overweight or pregnant

Those over 50 have a higher risk of hernia, possibly due to the muscles in the stomach wall becoming weaker with age.

The most common types of hernia requiring surgery are:

Groin

Inguinal HerniaThis is the most common type of hernia and is found in the groin. It is caused by a loop of bowel pushing through a weakness in the inguinal canal. The inguinal canal is a triangle-shaped opening between layers of abdominal muscle near the groin.

They are most common in men (98%) and occur when a loop of bowel slides down the narrow canal down towards the scrotum. The hernia usually appears as a swelling in the groin or enlargement of the scrotum, which may or may not be painful and often disappears when lying down.

Femoral HerniaThis type of hernia occurs most commonly in overweight women and occurs when part of the intestine passes down the natural canal through which the large blood vessels for the leg pass and make a swelling on the upper and inner part of the thigh.

T: + 44 (0)20 7563 1234 F: + 44 (0)20 7563 1212



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HERNIA I TYPES

HerniaA hernia is a protrusion of a viscus (an organ) beyond its normal confi nes and occurs in either the groin or the abdomen. This protrusion produces a swelling; if it clears on lying down, it is known as a reducible hernia, or if it fails to clear an irreducible hernia. Hernias can be painless, cause slight discomfort or be painful. They tend to get larger with time and can make it diffi cult to undertake normal activities.

Although hernias in adults can arise for a number of reasons some common examples are:

• persistent heavy coughing, • injury or surgery, • lifting, carrying or pushing heavy loads • straining to produce a bowel movements • straining to urinate e.g. men who have an enlarged prostate. • Being overweight or pregnant

Those over 50 have a higher risk of hernia, possibly due to the muscles in the stomach wall becoming weaker with age.

The most common types of hernia requiring surgery are:

Groin

Inguinal HerniaThis is the most common type of hernia and is found in the groin. It is caused by a loop of bowel pushing through a weakness in the inguinal canal. The inguinal canal is a triangle-shaped opening between layers of abdominal muscle near the groin.

They are most common in men (98%) and occur when a loop of bowel slides down the narrow canal down towards the scrotum. The hernia usually appears as a swelling in the groin or enlargement of the scrotum, which may or may not be painful and often disappears when lying down.

Femoral HerniaThis type of hernia occurs most commonly in overweight women and occurs when part of the intestine passes down the natural canal through which the large blood vessels for the leg pass and make a swelling on the upper and inner part of the thigh.


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Abdominal

UmbilicalAn umbilical hernia occurs when part of the intestine protrudes through a weakness in the abdominal wall, creating a soft swelling near the navel. They can cause abdominal pain.

EpigastricThis type of hernia is caused by a weakness in the upper abdomen, the intestine bulges between the breastbone and the navel and is most common in men.

IncisionalAn incisional hernia is the result of weakness following a surgical wound or scar in the wall of the abdomen.

The aim of our hernia repair is to have; • Minimal: o Incision o Discomfort o Loss of Leisure o Shave o Incapacity o Loss of Work o Hospital Stay o Immobilisation o Recurrence • Maximum strength


HERNIA I TYPES I ADMISSION

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Abdominal

UmbilicalAn umbilical hernia occurs when part of the intestine protrudes through a weakness in the abdominal wall, creating a soft swelling near the navel. They can cause abdominal pain.

EpigastricThis type of hernia is caused by a weakness in the upper abdomen, the intestine bulges between the breastbone and the navel and is most common in men.

IncisionalAn incisional hernia is the result of weakness following a surgical wound or scar in the wall of the abdomen.

The aim of our hernia repair is to have; • Minimal: o Incision o Discomfort o Loss of Leisure o Shave o Incapacity o Loss of Work o Hospital Stay o Immobilisation o Recurrence • Maximum strength


HERNIA I TYPES I ADMISSION


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HERNIA REHABILITATION PROGRAMMEThe hospital physiotherapist will show you how to do this and the Practice nurses are available for advice if you have any concerns.

Week 1 1st Day: Stand upright and walk 10 minutes. Thereafter, walk gently 4 times a day (10 minutes)

Week 2 Return to work: Sedentary occupation. Walk for 30 minutes twice a day for 4 days. Brisk walking or jogging, thereafter. Gentle sexual intercourse. May Drive

Week 3 Return to work: Light work. Running in straight lines. Gentle sit-ups and press-ups. Moderate gentle lifting (10 kgs)

Week 4 Return to work: Heavy occupation. Swimming (crawl). Cycling, running. Heavy lifting (15 kgs). Must avoid sudden movement

Week 5 All Activities Allowed


NOTE • While exercising, and afterwards, some discomfort will be experienced at the repair site.



Swelling at the operation site takes 8 to 12 weeks to clear completely.

HERNIA I REHABILITATION PROGRAMME

T: + 44 (0)20 7563 1234 F: + 44 (0)20 7563 1212



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HERNIA REHABILITATION PROGRAMMEThe hospital physiotherapist will show you how to do this and the Practice nurses are available for advice if you have any concerns.

Week 1 1st Day: Stand upright and walk 10 minutes. Thereafter, walk gently 4 times a day (10 minutes)

Week 2 Return to work: Sedentary occupation. Walk for 30 minutes twice a day for 4 days. Brisk walking or jogging, thereafter. Gentle sexual intercourse. May Drive

Week 3 Return to work: Light work. Running in straight lines. Gentle sit-ups and press-ups. Moderate gentle lifting (10 kgs)

Week 4 Return to work: Heavy occupation. Swimming (crawl). Cycling, running. Heavy lifting (15 kgs). Must avoid sudden movement

Week 5 All Activities Allowed


NOTE • While exercising, and afterwards, some discomfort will be experienced at the repair site.



Swelling at the operation site takes 8 to 12 weeks to clear completely.

HERNIA I REHABILITATION PROGRAMME


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The Gilmore Groin and Hernia Clinic, 108 Harley Street, London W1G 7ET

T: + 44 (0)20 7563 1234F: + 44 (0)20 7563 1212E: [email protected]

The Gilmore Groin and Hernia Clinic is a division of The London Breast Clinic Ltd. Reg No 2520520. Registered in England & Wales

Registered Offi ce:Whitewater Mill, Hook, HANTS RG27 9EH

Offi ce HoursMonday to Thursday, 7am - 6pmFriday, 7am - 5.30pm

VISITING USParkingParking meters are available on Harley Street, however, remember that it is in the congestion charging zone, telephone: 0845 900 1234. Parking meters are also available near by in Regents Park which are not in congestion charging zone.

There is a car park on Queen Anne Street which is accessed at the end of Harley Street via Cavendish Square. There is also a car park at Cavendish Square

Please note that Harley Street is within a one way traffi c system running north south from Marylebone Road to Cavendish Square.

Public Transport UndergroundThe nearest tube stations are: • Regents Park - Bakerloo Line • Oxford Circus - Bakerloo, Central and Victoria Lines • Great Portland Street - Circle, Metropolitan, Hammersmith and City Lines • Baker Street - Jubilee, Hammersmith and City, Metropolitan, Bakerloo and

Circle Lines

BusesBus numbers 18, 27, 30 and 205 stop at Marylebone Road at the top of Harley Street.

FOR FURTHER INFORMATION PLEASE VISIT:www.108harleystreet.co.uk

CONTACT US


ATAT

Medical Director - 108 Harley StreetMr O J A Gilmore MS FRCS FRCS(ED) F.INST SPORTS MED


TH ELONDONTHYRO IDC L I N I C

AT

The London Thyroid Clinic, 108 Harley Street, London W1G 7ET

T: + 44 (0)20 7563 1234F: + 44 (0)20 7563 1212E: [email protected]

The London Thyroid Clinic is a division of The London Breast Clinic Ltd. Reg No 2520520. Registered in England & Wales

Registered Offi ce:Whitewater Mill, Hook, HANTS RG27 9EH

Offi ce HoursMonday to Thursday, 7am - 6pmFriday 7am - 5.30pm

VISITING USParkingParking meters are available on Harley Street, however, remember that it is in the congestion charging zone, telephone: 0845 900 1234. Parking meters are also available near by in Regents Park which are not in congestion charging zone.

There is a car park on Queen Anne Street which is accessed at the end of Harley Street via Cavendish Square. There is also a car park at Cavendish Square

Please note that Harley Street is within a one way traffi c system running north south from Marylebone Road to Cavendish Square.

Public Transport UndergroundThe nearest tube stations are: • Regents Park - Bakerloo Line • Oxford Circus - Bakerloo, Central and Victoria Lines • Great Portland Street - Circle, Metropolitan, Hammersmith and City Lines • Baker Street - Jubilee, Hammersmith and City,

Metropolitan, Bakerloo and Circle Lines

BusesBus numbers 18, 27, 30 and 205 stop at Marylebone Road at the top of Harley Street.

FOR FURTHER INFORMATION PLEASE VISIT:www.108harleystreet.co.uk

CONTACT US

Medical Director - 108 Harley StreetMr O J A Gilmore MS FRCS FRCS(ED) F.INST SPORTS MED


the gilmore groin & hernia clinic - 108 harley street · t: + 44 (0)20 7563 1234 f: + 44 (0)20...

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