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In this Article
In this Article
- Do I Need Hernia Surgery?
- Types of Hernia Surgery
- Hernia Surgery Risks
- Non-Surgical Hernia Treatments
Hernias usually don’t get better on their own. They tend to get bigger. In rare cases, they can lead to life-threatening complications. That’s why doctors often recommend surgery. But not every hernia needs treatment right away. It depends on the size and symptoms.
Do I Need Hernia Surgery?
Your doctor will likely recommend it if any of these things happen:
- Tissue (such as the intestine) becomes trapped in the abdominal wall. This is called incarceration. If left untreated, it may lead to strangulation. That’s when the blood supply to the tissue gets cut off.
- The hernia becomes strangulated. This can cause permanent damage or even death. Call your doctor right away if you have a fever or nausea , sudden pain that gets worse, or a hernia that turns red, purple, or dark. You’ll need emergency surgery.
- The hernia causes pain or discomfort, or it’s growing larger.
You may be able to wait to have surgery if:
- Your hernia goes away when you lie down, or you can push it back into your belly
- It’s small, and causes few — or no — symptoms (these may never need surgery)
Talk to your doctor. He’ll monitor your hernia during your yearly physical.
Nearly all children and adults can have hernia surgery. If you’re seriously ill or very frail , you may choose not to have an operation. Your doctor can help you weigh the benefits of the procedure against your ability to recover.
Types of Hernia Surgery
Your doctor can remove your hernia in one of two ways. Both are done at a hospital or surgery center. You’ll usually go home within a few days. In many cases, you’ll be able to go home the same day as your procedure.
Open surgery: Before the operation, you’ll receive local or spinal anesthesia (it numbs the lower part of your body). Or you may receive general anesthesia (you’ll get medication through an IV so you’ll be asleep during the procedure).
The surgeon makes a cut (incision) to open your skin . He’ll gently push the hernia back into place, tie it off, or remove it. Then he’ll close the weak area of the muscle — where the hernia pushed through — with stitches . For larger hernias, your surgeon may add a piece of flexible mesh for extra support. It’ll help keep the hernia from coming back.
Laparoscopic surgery: In this surgery, your abdomen is inflated with a harmless gas. This gives the surgeon a better look of your organs. He’ll make a few small incisions (cuts) near the hernia. He’ll insert a thin tube with a tiny camera on the end (laparoscope). The surgeon uses images from the laparoscope as a guide to repair the hernia with mesh. For laparoscopic surgery, you’ll receive general anesthesia.
Recovery is usually faster with laparoscopic surgery: On average, patients are back to their normal routine a week sooner than with open surgery.
What kind of surgery you’ll need often depends on your hernia’s size, type, and location. Your doctor will also consider your lifestyle, health, and age.
Hernia Surgery Risks
This type of operation is normally very safe. But like all surgeries, having your hernia removed comes with a number of possible complications. They include:
- Infection of the wound
Blood clots : These can develop because you’re under anesthesia and don’t move for a long period of time.
- Pain: In most cases, the area will be sore as you heal. But some people develop chronic, long-lasting pain after surgery for a groin hernia , for example. Experts think the procedure may damage certain nerves. Laparoscopic surgery may cause less pain than an open procedure.
Nerve damage : Your stitches or staples may press on a nerve. Or a nerve might get trapped during the surgery. If you feel sharp or tingling pain, tell your doctor. You may need another procedure.
- Recurrence: The hernia could come back after the surgery. Research shows that using mesh can reduce your risk of this happening by half.
Non-Surgical Hernia Treatments
Your physician may recommend that you wear a corset, binder, or truss. These supportive undergarments apply gentle pressure on the hernia and keep it in place. They may ease discomfort or pain. They’re used if you aren’t able to have surgery, or for temporary relief before your procedure.
Only use these garments under your doctor’s supervision. In some cases, they may make a hernia worse or hide the signs of incarceration or strangulation.
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About Your Hernia Surgery
Hernia repair has been around for a long time. That means traditional techniques have been perfected while new options and materials have been developed. While not every technique is right for every hernia, they all have common goals: to provide the strongest repair and least chance of recurrence with the least possible discomfort and quickest recovery.
Your (Grand) Father’s Hernia Repair: Open Tension Repair
Until about 25 years ago, hernias were repaired one way, referred to as ‘open tension’ repair. Here’s what that means:
- Open — An incision of 3" to 6" is made in the abdomen to give the surgeon access to the hernia.
- Tension — The edges of healthy tissue around the hernia are pulled together and sewn with sutures.
- The incision is then closed with dissolving sutures or abdominal adhesive.
This method has been tried and true for decades and may be the only way to repair a very large hernia. The incision tends to be painful and recovery can take as long as five to six weeks. The incision also leaves a scar, although it’s usually very low on the abdomen. Tension repair has a higher recurrence rate than non-tension, or mesh, repair.
Today’s Hernia Repair Options — The Best Reason to Fix Your Hernia Early!
Today’s hernia repair options include new techniques and materials that can make surgery less invasive, recovery faster, and recurrence less likely. And the smaller your hernia (meaning the earlier you fix it), the more options you’re likely to have.
Non-Tension or Mesh Repair
Non-tension means just that. Instead of pulling the tissue around the hernia together, a piece of mesh is positioned to reinforce the area and fixed in place with sutures and/or staples.
The mesh is made of a flexible material that stays in the abdomen and encourages new tissue to grow into it.
Mesh repair has a lower incidence of recurrence than tension repair. There are also different kinds of mesh, including patches, plugs, three-dimensional, expanding, self-absorbing, and even self-gripping mesh that requires few to no sutures to keep it in place. A surgeon who specializes in hernia repair is most likely to have experience using the latest procedures. Ask which ones he or she uses, which may be best for you, and why. Sometimes the best procedure for you is the one with which your surgeon has the most experience and is most comfortable. Don’t hesitate to ask!
Laparoscopic or Closed Repair
Many inguinal hernias can be repaired using a ‘closed’ or laparoscopic procedure — especially when they’re smaller. Laparoscopic repair entails inserting special instruments through tiny incisions in the abdomen through which the surgeon is able to visualize and perform the procedure. Laparoscopic repair uses mesh for reinforcement, so it has a lower recurrence rate. Plus, a smaller incision means less discomfort after surgery, little to no scarring, and a quicker return to normal activity. Many people return to work within a few days.
How It Works
- Your surgeon makes three or four ¼" to ½" incisions in your abdomen. One is near your navel and the others lower down.
- A laparoscope, a fiber-optic tube with a tiny camera on the end, is inserted through one of the openings, allowing the surgeon to visualize the area on a TV monitor.
- The surgeon performs the procedure using tiny surgical instruments inserted through the other openings while viewing it on the TV monitor. The mesh is positioned and fastened in place with sutures and/or staples.
- The instruments are removed and the holes are closed with a stitch or two or with surgical tape.
While open hernia repair may be done under general, regional (spinal), or even local anesthesia with sedation, laparoscopic hernia repair is always done under general anesthesia. If the idea of general anesthesia makes you nervous, it shouldn’t. General anesthesia is extraordinarily safe with today’s precise administration and monitoring. Your anesthesiologist is present throughout your surgery and monitors you continuously. When your procedure is finished and the anesthesia is stopped, you’ll wake up very quickly.
And if you’re concerned about side effects from general anesthesia, such as nausea and vomiting or headaches, you should know these are rare — the exception rather than the rule. Even if you’re having open repair, your surgeon may prefer to perform the surgery with general anesthesia. It may be easier and more comfortable for you, too. After all, what’s easier than going to sleep, waking up and…it’s done?
Before Your Surgery
A few days before surgery, your surgeon may order a pre-op exam consisting of blood tests, an EKG (electrocardiogram), and a chest X-ray to be sure your heart and lungs are in good condition. You may be instructed to stop taking some over-the-counter medications for a week to 10 days before surgery, such as aspirin or ibuprofen (Advil), which can increase bleeding. Make sure your surgeon knows all the prescription and over-the-counter medications you take, including natural or nutritional supplements. You may also be given a prescription for pain medication to take after surgery, in case you need it. Fill it before your surgery, so you don’t have to think about it after.
The Day of Surgery
- You’ll arrive at the hospital the morning of your surgery; you’ll sign consent forms, change into a hospital cap and gown, have your blood pressure taken, and be started on an IV (intravenous line). The area of your hernia may need to be scrubbed and shaved to guard against infection.
- The anesthesiologist will meet with you and review the type of anesthesia you and your surgeon have decided on. You’ll be given medication to relax you (aka the "I don’t care medicine," because you won’t…).
- Next you’ll be taken to the operating room, your anesthesia will be administered and the next thing you know…
That’s It — You’re Done.
You’ll be waking up in the recovery room with your surgery behind you. Sound easier than dealing with your hernia? It is. Now you can concentrate on your recovery and getting back to your life.
Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.
About Your Hernia
About Your Recovery
|Traditional open repair requires one or two 3- to 6-inch incisions.||Laparoscopic repair requires three or four 1/4- to 1/2-inch incisions.|
Facts & Tips:
- Find a surgeon who specializes in hernia surgery and has experience with the latest techniques, to make sure you have the most options.
- Make sure your surgeon explains which procedure is recommended for you and why.
- Make sure to tell your surgeon about all medications and supplements you take: prescription, over the counter and natural.
- The following is a list of questions to ask your surgeon:
- Which hernia repair procedures are you most comfortable with/do you perform the most?
- Which one do you recommend to fix my hernia and why?
- What risks are associated with this type of surgery?
- Do I have more than one option?
- What kind of anesthesia will I need?
- What is the recurrence rate with the recommended procedure?
- Do I need to stay in the hospital?
- Will my insurance cover the surgery?
- Will I need pain medication after surgery?
- When will I be able to return to work?
- When and how often will I need to see you for follow-up visits?