Hernias & General Surgery

Inguinal hernias:

The commonest type of hernia, often caused by straining (coughing, heavy lifting, exercise). They are characterised by a swelling in the groin, which can disappear when lying flat. These hernias can also present with pain, and there is an association with Gilmore's groin (sportsman's hernia, see below). Surgical repair is by an open or laparoscopic technique, both of which techniques I perform, allowing me to tailor the surgery to each individual patient. These are typically day case procedures. Laparoscopic repairs are particularly recommended for recurrent or bilateral hernias. For more information see links below.

Further information on hernias:

http://www.spirehealthcare.com/ our-treatments/body-map-and-a-z/ a-z-treatments/hernia-surgery/

Epigastric & umbilical hernias:

These are also common, and present with a lump in the upper part of the abdomen. They can be unsightly, and cause discomfort. Surgical repair is usually straight forward, and depending on the size may involve a mesh to reinforce the tissues.

Other hernias:

Include femoral, incisional, and Spigelian hernias. Treatment can be performed with laparoscopic or open surgery; I am happy to discuss the different options for treatment, and the pros and cons of each procedure.

Sportsman's hernia (Gilmore's groin):

This condition can be very disruptive, particularly if you do a lot of sport and exercise. Sportsman's groin refers to pain within the groin, often coming on after exercise, and can be caused by a number of different pathophysiological conditions. It is caused by the large forces transmitted through the groin, as a number of muscle groups (abdominals, hip flexors, and adductors) meet within this area. Treatment initially involves assessment, investigation with an ultrasound and sometimes MRI, and physiotherapy. Surgery can be very effective if more conservative approaches fail, and can be performed laparoscopically or with an open technique.

Gallstones & gallbladder surgery:

Gallstones are very common, and can cause pain, typically in the upper right part of the abdomen. The mainstay of treatment for gallstones is a cholecystectomy (removal of the gallbladder). This is performed laparoscopically, and is usually a day-case procedure.

Further information on gallstones:

http://www.spirehealthcare.com/ Documents/Treatment%20Summary %20PDFs/Gallbladder%20Removal %20Treatment%20Summary.pdf

Abdominal pain:

There are many causes for abdominal pain, which can present acutely with severe pain, or have a more gradual / chronic course. Severe pains should be assessed urgently, by your own doctor, or at an Emergency Department. If an appointment is available, Mr Dowson is happy to assess patients urgently. Management of more chronic pains involves investigation to try and identify a cause; a range of treatment options are available.


Appendicitis usually presents as an emergency, with abdominal pain. Typically the pain is initially located in the central abdomen, and then as the pain develops moves to the right side. However, some people have persistent or recurrent abdominal discomfort, and may benefit from an elective operation. There may be an overlap with adhesions, non-specific abdominal pain, or IBS (irritable bowel) causing abdominal pain.

Non-specific abdominal pain:

This refers to abdominal pain where no specific cause can be identified. Surprisingly common, this can cause significant problems and be challenging to treat. A variety of options are available; this condition may be related to irritable bowel.


Other patients may have adhesions (intra-abdominal scarring), which typically occur after previous surgery or infections within the abdomen, although in some patients adhesions can form spontaneously (referred to as congenital adhesions). Adhesions can cause obstruction of the small bowel, and whilst this will often settle without an operation, surgery is sometimes required to treat this. Adhesions can also be a cause of chronic abdominal pain.

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