An inguinal hernia occurs when soft tissue — usually part of the membrane lining the abdominal cavity (omentum) or part of the intestine — protrudes through a weak point in the abdominal muscles. The resulting bulge can be painful, especially when you cough, bend over or lift a heavy object. Hernia repair refers to a surgical operation for the correction of a hernia.
Why Have Hernia Repair Surgery?
Surgery is the only way to repair a hernia, because they do not heal or resolve otherwise. Hernias, depending on the type, may cause symptoms such as severe pain and other serious problems like bowel obstruction and infection.
Types of Hernia Repair Surgery
Open Hernia Repair Surgery:
Depending on the physician and the patient’s partiality, as well as the patient’s health, either general anesthesia (patient is unconscious), epidural or spinal anesthesia (large area of the body numbed), or local anesthesia (area directly surrounding hernia numbed) can be used. Local anesthesia is usually used in combination with sedatives (causes drowsiness and relaxation).
For open hernia surgery, the physician makes an incision near the site of the hernia, and the intestine or other tissue that has filled the hernia sac is moved back to the abdominal cavity. The surplus sac may be removed or tied off. Different methods of open hernia repair surgery include:
- Primary repair (sutured repair)—sewing abdominal wall tissues back together using sutures.
- Patch repair (tension free repair)—attaching a patch over the weak area surrounding the hernia in front of the muscles.
- Plug and patch repair—A plug specifically used to treat inguinal hernias is put inside the inguinal hernia to strengthen and brace weak tissue. Then, a patch is put over the area.
Following the performance of any of these surgical methods, the physician closes the incision on the skin with stitches, surgical tape, staples, or special glue.
Laparoscopic hernia repair surgery requires general anesthesia (patient is unconscious).
During laparoscopic hernia repair surgery, a physician usually makes four or five tiny incisions in the region around the hernia. A laparoscope is a small scope attached to a video camera. The physician inserts the laparoscope into one of the small incisions and is then able to see the hernia and surrounding tissue and organs up on a video monitor.
The surgeon distends the abdomen with carbon dioxide gas, and then small surgical instruments are inserted into the other small incisions to repair the hernia. The hernia is repaired using the ‘patch repair’ method (see description in Open Hernia Repair Surgery above), with the patch being placed behind the muscles. The physician then releases the carbon dioxide gas from the abdomen and closes the small incisions.
This method of surgery presents the advantages of less recovery time than open surgery, less post-operative pain, minimized recurrence of hernias, and lessened complications.
Risks and Complications of Hernia Repair Surgery
There are some risks and complications associated with hernia repair surgery. The patient should contact their physician immediately if they experience any of the following symptoms after surgery:
- Nausea or vomiting.
- Fever of 101 degrees Fahrenheit/ 38 degrees Celsius or higher.
- Problems urinating.
- Persistent pain after medication.
- Increased redness or drainage from incisions.
- Extreme bruising or swelling (some bruising and swelling is normal).
What to Expect Before Hernia Repair Surgery
Before hernia repair surgery a physician will conduct a medical evaluation usually including a review of the patient’s surgical and medical history, a physical exam, and a discussion of the medications, diet, and any supplements being taken. The physician will also perform lab tests such as blood work and x-rays if needed, as well as pulmonary or cardiac tests.
The physician will discuss with the patient whether they will undergo open or laparoscopic hernia repair surgery and the risks and advantages of both.
The week before surgery the patient will most likely need to stop taking aspirin or any products that contain aspirin. The physician will advise the patient on any other medications or herbal supplements they need to stop taking prior to surgery. Smokers should try to quit smoking as much as possible prior to surgery.
Hernia repair surgery is typically an outpatient surgery, so patients usually return home the same day as surgery. The patient will need to arrange for someone to take them to the hospital and then home from the hospital on the day of surgery. Also, patients may want to arrange for someone to stay with them at home for the first few days after surgery.
The day before surgery, the patient may be asked to take a laxative to clear the intestines. The patient may need to refrain from eating after a certain time the day before surgery, as directed by their physician, and drink clear liquids only until midnight.
If staying in the hospital overnight, the patient should pack an overnight bag, leaving valuables at home. Patients should prepare to wear loose clothing home following surgery and for several days thereafter.
What to Expect After Hernia Repair Surgery
After returning home from hernia repair surgery, it typically takes several days to recover from laparoscopic surgery and perhaps longer from open surgery. To help the recovery process patients should:
- Place an ice pack around the surgical incision site three to five times a day for fifteen to twenty minutes at a time, to decrease swelling.
- Take the pain medication prescribed by the physician as directed and on time.
- When the doctor advises (usually a day or two after surgery), start showering or bathing again.
- Frequently take short walks as soon possible to increase circulation and decrease the risk of blood clots in the legs.
- Refrain from lifting anything heavy for a minimum of a week. The surgeon will give the patient any special recommendations.
- Return to the doctor for a follow-up appointment one to three weeks post surgery.
- Drink ample amounts of water and eat healthily.
- Follow the physician’s recommendations about when it is safe to return to work.
Outcomes of Hernia Repair Surgery
Generally hernia repair surgery has a high success rate. Although laparoscopic hernia repair surgery has been shown to be effective and safe, this specific method has only been used for hernia repair for a few years, and long-term outcomes are not available.
Read about the different types of hernias.