Herniorrhaphy: What to Expect with Hernia Repair Surgery

Purpose, types, and outcomes of hernia surgeries

A hernia is when an organ or tissue protrudes through a weak area of muscle. This is most common in the abdomen. Hernia repair surgery may be called a hernioplasty or herniorrhaphy. During this surgery, the displaced tissue is returned back into the body and the weak spot is stitched or patched up.

Hernia repair surgery is common. It is generally very safe and effective. If you or a loved one are considering this surgery, though, it is important to understand its potential risks and the recovery process.

This article looks at hernia repair surgery and its purpose. It also discusses how to prepare for surgery, what the risks are, and what you should expect while you recover.

Types of Hernia Repair Surgery
Verywell / Hilary Allison

What Is Hernia Repair Surgery?

Hernia repair surgery is performed by a general surgeon. It is usually done in a hospital or an outpatient surgical center. An outpatient surgical center is a facility that does not require an overnight stay, so you won't have to stay long after hernia surgery unless there are complications.

The surgery may be done in adults and children. It usually takes less than an hour or two.

Hernia repair surgery is done with anesthesia. The type you receive depends on the surgical technique. It may also depend on if the surgery is an emergency or not.

The three types of anesthesia that you may receive include:

  • General anesthesia: This puts you in a sleep-like state.
  • Regional anesthesia: This type is given through the spinal cord. It numbs a large part of your body.
  • Local anesthesia with sedation: This numbs a smaller part of your body. The sedation relaxes you and may or may not make you fall asleep.

The Difference Between Hernioplasty and Herniorrhaphy

Herniorrhaphy refers to a surgical technique that relies primarily on sutures to secure herniated tissue in its proper location and strengthen the weakened muscle at the site. Hernioplasty is a different technique that relies primarily on placing synthetic mesh to reinforce the weakened muscle site.

Surgical Techniques

Hernias are repaired with one of three types of surgery:

  • Open surgery
  • Laparoscopic surgery
  • Minimally invasive robotic surgery

The technique used is based on several variables. These may include:

  • The size and location of the hernia
  • The patient's age
  • The patient's overall health

During open surgery, the surgeon makes a cut called an incision near the hernia. The bulging tissue is returned back into the body through the incision.

The weak muscle that allowed the hernia to occur is then repaired. It may be stitched back together or, more commonly, patched with a synthetic material called mesh.

During laparoscopic surgery, multiple tiny incisions are made around the hernia. Long, thin surgical tools are inserted through these incisions.

One of these tools has a camera attached to it. The camera projects images onto a TV screen. This lets the surgeon view the inside of the body. Other tools are used to repair the hernia in the same way as with open surgery.

Robotic surgery also involves a camera and the use of very small surgical tools attached to robotic arms. A specially-trained surgeon controls the robotic arms from a viewing screen, which is usually situated in the same room as the operating table.

Open surgery is a more traditional way to repair a hernia. Laparoscopic surgery is generally less painful and often lets patients recover faster.

Hernia repair may be done laparoscopically, robotically, or with open surgery. Laparoscopic surgery typically has a faster recovery time.

Contraindications

There are no absolute contraindications to undergoing hernia repair surgery. This means there are no medical conditions that will exclude you from being able to have hernia surgery.

There may be relative contraindications. These are circumstances that make extra preparation necessary before you can have the surgery. These include:

Purposes of Hernia Surgery

Most hernias occur within the abdominal wall. With these hernias, there is a weakness or tear in the outer abdominal muscles. These muscles normally keep organs or tissues, like the intestines, inside.

In an inguinal hernia, the intestines or fatty tissue bulges through the abdominal muscles in the groin area. About 75% of all hernias are inguinal. These are most common in biological males.

Another type of abdominal wall hernia is a femoral hernia. These occur a bit lower in the groin than inguinal hernias. They are more common in biological females, and carry higher risks if not repaired.

Other types of abdominal wall hernias include:

  • Umbilical hernia, a hernia near the belly button that's typically not serious. It is most common in newborns and usually closes on its own. These hernias are more concerning in adults.
  • Epigastric hernia, a hernia that requires surgery but isn't usually an emergency
  • Incisional hernia, one that develops after abdominal surgery and often needs further repair

Reducible Hernia

A reducible hernia is one that bulges with pressure. This might happen when you're lifting something heavy. It might also happen when you're straining to have a bowel movement.

Reducible hernias return inside the body when the pressure is gone. You may also be able to push them back with gentle pressure from the outside.

These hernias are not considered an emergency, but still require a surgical repair.

Incarcerated Hernia

An incarcerated hernia remains in the "out" position. It can't be pushed back.

These hernias can become strangulated. This means the bulging tissue loses blood flow. This can be life-threatening and requires emergency surgery.

Irreducible hernias can lead to permanent damage. For example, 15% of boys with an irreducible hernia will experience testicular damage and atrophy.

Surgeons recommend hernia repair surgery for most hernias. This will improve symptoms and prevent hernia incarceration.

In certain cases, watchful waiting may be recommended. This means your doctor may want to monitor your condition for a while before making a decision about surgery. For example:

  • You may have an inguinal hernia that has no symptoms and isn't getting bigger.
  • You may have a small, umbilical hernia that has no symptoms. This is a hernia that appears near the belly button. These types of hernias usually aren't serious.
  • You may have a sliding hiatal hernia but no reflux disease. This is when your stomach and part of your esophagus slide into your chest through a hole in your diaphragm called the esophageal hiatus. This is the most common type of hiatal hernia. It is not usually dangerous.

Preparing for Hernia Surgery

Your surgeon will give you instructions on how to prepare for your surgery.

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, you should avoid taking aspirin or non-steroidal anti-inflammatory medications (NSAIDs) a week before surgery.
  • Stop eating for a period of time prior to surgery. This depends on the surgical technique and type of anesthesia.
  • Arrange for someone to drive you home after the surgery.
  • Pack personal items if a hospital stay is needed. This is not typical.

Follow your surgeon's instructions when preparing for your surgery. For example, you will need to avoid NSAIDs in the weeks leading up to your procedure. You may also need to stop eating for a short period before your surgery.

What to Expect on the Day of Surgery

What happens the day of your surgery will depend on certain factors. The steps will vary depending on the type of surgery you will have and which anesthesia you will receive.

If you are having laparoscopic surgery, you can expect the following steps:

  • After you arrive you will change into a gown. Members of your surgical team will meet with you to briefly review the surgery.
  • You will be taken into the operating room. You will be given medication to put you into a sleep-like state.
  • While asleep, the surgeon will inflate your abdomen with air. This makes it easier for the surgeon to see your internal organs and tissues.
  • A small incision will be made at your navel. The surgeon will insert a laparoscope, a long, thin surgical tool with a camera attached to it.
  • The camera will project images onto a TV screen. This lets the surgeon see what is happening inside your body.
  • Additional small incisions will then be made. Other surgical tools will be inserted through these incisions.
  • The surgeon will use the surgical tools to return the bulging tissue back into its place.
  • The surgeon will then stitch or patch the weakness in the abdominal wall.
  • The surgeon will then deflate your abdomen. The small incision sites will be closed with stitches or surgical tape.

After the surgery, you will be moved to a recovery room. You will spend a few hours there while the anesthesia wears off. When symptoms like pain are under control, you will be able to go home.

Recovery From Hernia Surgery

Recovery time for hernia repair surgery varies depending on what kind of surgery you had. For laparoscopic surgery, it's typically about one to two weeks. For open repair surgery, it's usually about three weeks.

Make sure to follow your surgeon's post-operative instructions. This will help optimize healing and prevent complications. These instructions may include:

  • Use an ice pack or cold compress every couple of hours for 15 minutes. This will help to reduce swelling. Don't put the ice pack directly on your skin.
  • Take Tylenol (acetaminophen) to control pain. If your pain is more significant, you may be prescribed an opioid. Take as directed.
  • Get up and walk around five to six times per day. This will help prevent blood clots.
  • Wash your hands before and after touching your incisions. This helps to prevent infection.
  • If you had laparoscopic surgery, your surgeon will advise you on how long to avoid strenuous exercise.

When to Seek Medical Attention

Contact your healthcare provider if you notice any of these symptoms while you're recovering:

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

Outcomes and Long-Term Care

Hernias will not heal or resolve on their own. The main benefit of surgery is that, in most cases, it fixes the problem. This means that after you recover, you should be able to return to your normal routine and daily life. You should not have pain, discomfort, or a visible bulge.

In most cases, the long-term prognosis for people who have hernia surgeries is good. Inguinal hernia repairs are generally uncomplicated, although about 10% of people will experience chronic pain and there may be recurrence of the hernia.

About one in six people will have a hernia recurrence after certain abdominal wall repairs, with some variation based on the technique used. There are few short-term complications with incisional hernia repair, although less is known about the long-term impacts.

In the long-term, your surgeon will want you to stay healthy. If you have any persistent symptoms, especially pain, let your surgeon know. If you are obese, your surgeon may recommend losing weight to prevent a recurrence.

Potential Risks of Hernia Repair Surgery

The main risks of hernia repair surgery include:

  • Bleeding or hematoma. This is when blood collects under the surgical site.
  • Seroma, or 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, such as constipation or trouble urinating
  • Nerve or tissue injury or damage
  • Hernia recurrence

All surgeries have some risk. The risks in hernia surgery are low but may include chronic pain, nerve or tissue damage, and hernia recurrence.

Summary

A hernia is when tissue or an organ bulges through a weak area of muscle. Hernia repair is a surgery that can correct this problem. Hernia repair surgery is more urgent when the hernia is incarcerated or permanently in the out position. Surgery can prevent the hernia from becoming strangulated.

Some hernias may not require surgery, at least initially. Your healthcare provider may recommend watchful waiting instead.

Follow your healthcare provider's instructions as you navigate surgery preparation and recovery. Be sure to contact your provider if you have complications, including signs of infection or persistent pain. 

A Word From Verywell

Hernia repair surgery can be done with two different techniques, and open procedures also allow for a few anesthesia options. If hernia repair surgery is right for you, your surgeon will be your primary source of information about your options and the best approach.

Frequently Asked Questions

  • What happens if a hernia is left untreated?

    A hernia will not heal on its own. Left untreated, a hernia will become larger and can cause serious health problems. The hernia can become trapped or incarcerated. It may become strangulated, cutting off blood flow to the trapped tissue. This can be a life-threatening emergency. 

  • Is hernia surgery life-threatening?

    All surgical procedures carry risks. Hernia surgery is typically not complicated. The risk of death generally is very low. The chance of complications is higher after emergency hernia surgery than it is after scheduled surgery. 

    The main risks associated with hernia surgery are:

    • Bleeding
    • Infection
    • Bowel or urinary tract issues
    • Nerve or tissue damage
    • Chronic post-operative pain
    • Fluid collection at the surgical site.
  • How long does it take to heal after hernia surgery?

    Recovery can take a few weeks. If the surgery was performed laparoscopically, healing could take as little as a week to two weeks. Open hernia surgery will take longer to heal. It typically takes three weeks to a month to recover from open hernia surgery. 

  • Are there non-surgical options to treat hernias?

    Generally speaking, no. Hernias require surgical treatment. In some cases, your healthcare provider may opt for a watchful waiting approach if you have no symptoms or to see if the hernia worsens. However, there is much you can do to prevent hernias, such as maintaining a healthy weight and exercising.

31 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. Kaiser Permanente. Open inguinal hernia repair (herniorrhaphy, hernioplasty).

  2. American Society of Anesthesiologists. Hernia surgery.

  3. Harvard Medical School. Hernia repair.

  4. Yale Medicine. Anesthesia for hernia repair.

  5. Penn Medicine. Hernia Surgery & Repair.

  6. Mahmoudvand H, Forutani S, Nadri S. Comparison of Treatment Outcomes of Surgical Repair in Inguinal Hernia with Classic versus Preperitoneal Methods on Reduction of Postoperative Complications. Biomed Res Int. 2017;2017:3785302. doi:10.1155/2017/3785302.

  7. MedStar Health. Open hernia repair.

  8. American College of Surgeons. Groin hernia repair: inguinal and femoral.

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

  10. Pielaciński K, Puła B, Szczepanik AB. Totally extraperitoneal inguinal hernia repair in patients with hemophilia and von Willebrand disease. Prospective controlled study. wiitm. 2021;16(3):552-559. doi:10.5114/wiitm.2021.103953

  11. Johna S. Laparoscopic incisional hernia repair in obese patientsJSLS. 2005;9(1):47-50.

  12. LeBlanch KE, LeBlanc LL, LeBlanc KA. Inguinal hernias: diagnosis and management. Am Fam Physician. 2013;87(12):844-848.

  13. University of Michigan Health. Abdominal wall hernias.

  14. Department of Health, State Government of Victoria, Australia. Hernias.

  15. Yeap E, Pacilli M, Nataraja RM. Inguinal hernias in children. Aust J Gen Pract. 2020 Jan-Feb;49(1-2):38-43. doi:10.31128/AJGP-08-19-5037.

  16. Berger D. Evidence-based hernia treatment in adults. Dtsch Arztebl Int. 2016;113(9):150–158. doi:10.3238/arztebl.2016.0150

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

  18. Brooks DC. Overview of abdominal wall hernias in adults. In: Rosen M, ed. UpToDate. Waltham, Mass: UpToDate; 2021.

  19. Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). Guidelines for the management of hiatal hernia.

  20. Johns Hopkins Medicine. Preparing for hernia surgery.

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

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

  23. University of Michigan. Open inguinal hernia repair (herniorrhaphy, hernioplasty).

  24. Kadakia N, Mudgway R, Vo J, Vong V, Seto T, Bortz P, et al. Long-Term Outcomes of Ventral Hernia Repair: An 11-Year Follow-Up. Cureus. 2020 Aug 2;12(8):e9523. doi:10.7759/cureus.9523. 

  25. Soare AM, Cârţu D, Nechita SL, Andronic O, Șurlin V. Complications of Intraperitoneal Mesh Techniques for Incisional Hernia - A Systematic Review. Chirurgia (Bucur). 2021 Dec;116(6 Suppl):S36-S42. PMID: 35274610.

  26. 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;21(5):729-735. doi:10.1007/s10029-017-1634-7

  27. 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;2(3):174–177. doi:10.4103/0972-9941.27734

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

  29. Mayo Clinic. Inguinal hernia.

  30. Nilsson H, Stylianidis G, Haapamäki M, Nilsson E, Nordin P. Mortality after groin hernia surgery. Ann Surg. 2007;245(4):656-60. doi:10.1097/01.sla.0000251364.32698.4b

  31. Northeast Georgia Health System. If I leave it alone, will my hernia heal on its own?

Additional Reading

By Jennifer Whitlock, RN, MSN, FN
Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine.