Repair Surgery for Different Types of Hernias

Surgeons picking mesh off an instrument tray

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A hernia is an abdominal defect common to both men and women that happens when a weakness in a muscle allows organs or tissue to bulge through. Hernias range in severity from barely noticeable to life-threatening, depending on the size of the defect and the organs involved. These factors also determine which hernias require surgery.

In some cases, hernia surgery is performed to remove the annoying or unsightly bulge; in other cases, severe organ damage and even death can occur if surgery is not performed immediately to repair the problem.

Does Your Hernia Require Surgery?

Your doctor will determine if your hernia requires surgery. Some hernias may be recommended for surgical repair based on discomfort, severity, and in certain cases, medical emergency.

Hernias generally occur in the groin (inguinal or femoral), abdomen (epigastric or umbilical), within the torso (hiatal or congenital diaphragmatic hernia), or as a result of a previous abdominal surgery (incisional).

It's important to know that hernias do not heal on their own. They can remain asymptomatic for a long time and be generally benign, but they can also worsen, sometimes quickly.

A hernia that bulges out with abdominal pressure (lifting something heavy, 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" and aren't as severe.

However, hernias that remain in the “out” position are “irreducible" or “incarcerated," and surgery may be indicated.

An incarcerated hernia can become an emergency if it “strangulates,” meaning that the bulging tissue loses blood flow. This can be life-threatening and requires immediate surgery.

When to Call a Doctor

A hernia becomes an emergency when there is severe pain at the site, often caused by a lack of blood flow to the tissue bulging through the muscle. Also, if a hernia changes color, such as gray/ashen or dark red/purple, blood flow may have been cut off and the hernia is strangulating.

Types of Hernia Surgery

There are two types of hernia surgery:

Open surgery. The surgeon makes a single incision at the hernia site and the bulging tissue is either removed or pushed back into the body.

Laparoscopic surgery. The surgeon makes a series of small incisions around the hernia and uses a laparoscope (a thin lighted tube with a camera) to see. Gas may be pumped under the skin to expand the area for the surgeon to work. Instruments are inserted through the other incisions to repair the hernia.

Hernia Surgery Techniques

Every hernia surgery is unique and your surgeon may use different techniques depending on your individual case.

Anesthesia. Your surgeon may recommend general anesthesia (you're knocked out for the entire procedure) or regional anesthesia (an epidural injection in your spine that numbs you from the waist down).

Some research has shown regional anesthesia patients had lower post-operative pain scores after inguinal hernia repair and began pain medication later than general anesthesia patients. Your doctor can help guide which method is best for your case.

Stitches and mesh. Your surgeon will repair your hernia with stitches, but may also use surgical mesh to strengthen the repair. Mesh can be non-absorbable (a permanent implant) or absorbable (designed to degrade over time as tissue heals and strengthens).

According to the FDA, research has consistently shown lower rates of hernia recurrence when mesh is used. It is worth noting that past complications from surgical mesh were associated with recalled products that are no longer on the market.

After Surgery

There is no standard recovery from hernia surgery as there are many types of hernias. Some hernia surgeries are large and extensive procedures, while others can be performed on an outpatient basis with the patient returning home the same day. In most cases, patients can return to normal activity in two to four weeks.

Your surgeon will give you specific instructions to follow during immediate post-op recovery and long-term (this will include physical limitations such as no lifting). Don't deviate from them.

The most important post-surgical activity is being vigilant for the most common hernia surgical complications:

  • Pain
  • Infection
  • Hernia recurrence
  • Adhesion (different tissues sticking together)
  • Bowel obstruction

Notify your doctor immediately if you experience any abnormalities in your recovery and healing.

You'll also want to prevent an incisional hernia later on (where tissue protrudes from a previous surgical incision), so protect your incision while it heals. When you rise from a seated position, sneeze or cough, or bear down from a bowel movement, gently hold pressure on the incision until the activity is over.

A Word From Verywell

Hernia surgery isn't generally serious, but it can be. If surgery is recommended, your surgeon will be your primary source of information specific to your case, helping you understand what to expect before, during, and after the procedure.

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Article Sources

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  1. National Institutes of Health. Medline Plus. Inguinal hernia repair.

  2. Bakota B, Kopljar M, Baranovic S, Miletic M, Marinovic M, Vidovic D. Should we abandon regional anesthesia in open inguinal hernia repair in adults?. Eur J Med Res. 2015;20:76. doi:10.1186/s40001-015-0170-0

  3. U.S. Food and Drug Administration. Hernia surgical mesh implants.

  4. National Health Services. Inguinal hernia repair recovery. Updated June 14, 2018.