Hernia Repair Surgery: Overview

In This Article

A hernia occurs when an organ or tissue protrudes through a weak muscular area within the body, usually the abdominal wall. Hernia repair surgery—also called a herniorrhaphy or hernioplasty—involves returning the displaced tissue back into the body and stitching or patching up the weak spot.

While hernia repair surgery is common and generally very safe and effective, it's important to have knowledge about its potential risks and the recovery process if you or a loved one are considering it.

Types of Hernia Repair Surgery
Verywell / Hilary Allison

What Is Hernia Repair Surgery?

Hernia repair surgery is performed by a general surgeon in an outpatient surgical center or in a hospital. The surgery may be done in adults and children, and it is usually completed in less than an hour or two.

Depending on various factors, like the surgical technique used to repair the hernia and whether the surgery is elective or emergent, you may be given one of the following three types of anesthesia:

  • General anesthesia
  • Regional (spinal) anesthesia
  • Local anesthesia with sedation

Surgical Techniques

Hernias are repaired through open surgery or laparoscopically. The technique used is based on several variables, like the size and location of the hernia, the patient's age, and their overall health.

  • Open surgery: The surgeon makes an incision (cut) near the hernia and returns the bulging tissue back into the body. The weakened muscle that allowed the hernia to occur in the first place is stitched back together or, more commonly, patched with a synthetic material called mesh.
  • Laparoscopic surgery: The surgeon makes multiple, tiny incisions around the hernia site to allow for the insertion of long, thin surgical tools. One of the tools has a camera attached to it, so the surgeon can view images of the inside of the body that are projected onto a TV screen. These tools are then used to repair the hernia in the same way as with open surgery.

While open surgery is the traditional way to repair a hernia, laparoscopic surgery often allows patients to recover faster and causes less pain. That said, laparoscopic surgery requires that a patient undergo general anesthesia, whereas traditional hernia repair can be done under general, regional, or local anesthesia.

Contraindications

There are no absolute contraindications to undergoing hernia repair surgery.

Relative contraindications, or circumstances under which patients may need additional preparation prior to undergoing the surgery, include:

Purpose of Hernia Repair Surgery

The vast majority of hernias occur within the abdominal wall. With abdominal wall hernias, there is a weakness or tear in the outer abdominal muscles that normally keep various organs or tissues, like the intestines, inside.

For example, with an inguinal hernia (which accounts for 75% of all hernias and is most common in men), the intestines or fatty tissue bulges through a weakness in the abdominal muscles located in the groin area. 

A femoral hernia is another type of abdominal wall hernia. More common in women, it occurs a bit lower in the groin than inguinal hernias.

Other types of abdominal wall hernias include:

A hernia that bulges out with abdominal pressure (e.g., when lifting something heavy or straining for a bowel movement) but returns inside the body when the pressure is gone or with gentle pressure from the outside is referred to as reducible. These hernias are not considered severe or serious.

Hernias that remain trapped in the “out” position and cannot be pushed back in are considered incarcerated. An incarcerated hernia can become an emergency if it strangulates, meaning that the bulging, trapped tissue loses blood flow. This can be life-threatening and requires emergent surgery.

To improve symptoms and to prevent adverse events like hernia incarceration, surgeons recommend elective surgical repair for most hernias.

That said, "watchful waiting," rather than surgery, may be reasonable in certain cases. For example:

  • A male patient with an asymptomatic inguinal hernia (that is not getting larger) who wants to avoid surgery
  • A patient with a small, asymptomatic umbilical hernia
  • A patient with a sliding (type 1) hiatal hernia without reflux disease

How to Prepare

Once you have scheduled your hernia surgery repair (assuming it is elective), your surgeon will provide you with instructions on how to prepare for the procedure. 

These instructions may include:

  • Wear comfortable, loose-fitting clothing on the day of your surgery.
  • Stop taking certain medications for a period of time before surgery (for example, non-steroidal anti-inflammatory medications, or NSAIDs a week before surgery).
  • Stop eating for a period of time prior to surgery (depends on the surgical technique and type of anesthesia used).
  • Arrange to have someone drive you home after the procedure.
  • Pack personal items if a hospital stay is needed (this is not typical).

What to Expect on the Day of Surgery

The flow of your surgery day will depend on factors like the type of surgery you are undergoing (open vs. laparoscopic) and the anesthesia you receive.

For a laparoscopic hernia repair, you can expect the following steps:

  • Upon arrival, you will change into a gown and members of your surgical and anesthesia teams will meet with you to briefly review the surgery.
  • You will be taken into the operating room where you will be given medication to put you to sleep.
  • While asleep, the surgeon will inflate your stomach with air to allow for better visualization of your internal organs and tissues.
  • A small incision will be made at your navel through which a long, thin surgical tool that has a camera attached to it (called a laparoscope) is inserted.
  • Additional small incisions will then be made in your abdomen through which other surgical tools are inserted.
  • Using the camera and projected images on a TV screen, the surgeon will use the surgical tools to return the bulging tissue back into its place.
  • The weakness in the abdominal wall will then be stitched closed or patched with mesh.
  • The abdomen will be deflated and the small incision sites will be closed with stitches or surgical tape.

After the surgery, you will be taken to a recovery room for a few hours. Once the anesthesia has worn off and any symptoms, like pain, are under control, you will be able to go home.

Recovery

The recovery from hernia repair surgery is typically about one to two weeks for laparoscopic surgery and three weeks for open repair surgery.

In order to optimize healing and help prevent complications, it's important to carefully adhere to your surgeon's post-operative instructions

These instructions may include the following:

  • To reduce swelling, place an ice pack or cold compress (not directly on your skin) every couple of hours for 15 minutes.
  • To control pain, take Tylenol (acetaminophen) or, if more significant, your prescribed opioid as directed.
  • To prevent a blood clot after surgery, be sure to get up and walk around five to six times per day.
  • To prevent infection, wash your hands before and after touching your incision site(s).
  • Avoid strenuous exercise for four weeks for laparoscopic surgery or six weeks for open surgery.

When to Seek Medical Attention

During your recovery, be sure to contact your doctor if you notice any of the following symptoms:

  • Persistent, severe, or worsening pain
  • Fever
  • Signs of infections from the surgical site—warmth, redness, increased swelling, and/or abnormal drainage
  • Persistent vomiting
  • No bowel movement by day two or three after surgery

Long-Term Care

Since hernias will not heal or resolve on their own, the main benefit of surgery is that it offers definitive treatment (in most cases). This means that after recovering from surgery, you can hopefully return to your normal routine and daily life without any pain, discomfort, or visible bulge.

In the long-term, your surgeon will want you to stay healthy and keep them abreast of any persistent symptoms, especially pain. Unfortunately, a small subset of patients develop chronic, usually nerve-related pain after hernia repair.

Finally, while hernia recurrence is uncommon after surgery, it is possible. To prevent a recurrence, your surgeon may recommend that you lose weight if you are obese.

Potential Risks

The main risks associated with undergoing hernia repair surgery include:

  • Bleeding or hematoma (when blood collects under the surgical site)
  • Seroma (fluid collection under the surgical site)
  • Infection, potentially of the surgical site or the surgical mesh used for repair
  • Chronic postoperative pain
  • Bowel or urination issues (e.g., constipation or difficulty urinating)
  • Nerve or tissue (e.g., bowel) injury or damage
  • Hernia recurrence

A Word From Verywell

Hernia repair surgery has come a long way. Surgeons can now choose between two different types of techniques, with an open procedure also allowing for a few anesthesia options. If hernia repair surgery is recommended for you, your surgeon will be your primary source of information specific to your case, helping you understand what the best approach is for you.

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Harvard Health. (December 2018). Hernia Repair.

  2. HerniaSurge Group. International guidelines for groin hernia managementHernia. 2018;22(1):1–165. doi:10.1007/s10029-017-1668-x

  3. Bittner R, Schwarz J. Inguinal hernia repair: current surgical techniques. Langenbecks Arch Surg. 2012 Feb;397(2):271-82. doi:10.1007/s00423-011-0875-7

  4. Hassler KR, Saxena P, Baltazar-Ford KS. (Updated June 2020). Open Inguinal Hernia Repair. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-

  5. LeBlanch KE, LeBlanc LL, LeBlanc KA. Inguinal Hernias: Diagnosis and Management. Am Fam Physician. 2013 Jun 15;87(12):844-848.

  6. Berger D. Evidence-Based Hernia Treatment in Adults. Dtsch Arztebl Int. 2016 Mar; 113(9): 150–158.

  7. Brooks DC. (2020). Overview of abdominal wall hernias in adults. Rosen M, ed. UpToDate. Waltham, MA: UpToDate.

  8. Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). Guidelines for the Management of Hiatal Hernia. April 2013.

  9. Johns Hopkins Medicine. Preparing for hernia surgery.

  10. University of Wisconsin Health. Laparoscopic inguinal hernia repair.

  11. Johns Hopkins Medicine. What to expect after hernia surgery.

  12. University of Michigan. (August 2019). Open Inguinal Hernia Repair (Herniorrhaphy, Hernioplasty).

  13. American College of Surgeons. (2018). Groin Hernia Repair: Inguinal and Femoral.

  14. Schjøth-Iversen L, Refsum A, Brudvik KW. Factors associated with hernia recurrence after laparoscopic total extraperitoneal repair for inguinal hernia: a 2-year prospective cohort study. Hernia. 2017 Oct;21(5):729-735. doi:10.1007/s10029-017-1634-7

  15. Chowbey PK, Pithawala M, Khullar R, Sharma A, Soni V, Baijal M. Complications in groin hernia surgery and the way out. J Minim Access Surg. 2006 Sep; 2(3): 174–177. doi:10.4103/0972-9941.27734

  16. Andresen K, Rosenberg J. Management of chronic pain after hernia repair. J Pain Res. 2018; 11: 675–681. doi:10.2147/JPR.S127820

Additional Reading