Hernia repair surgery – Hernia surgery & repair - Inguinal hernia repair – Umbilical hernia repair – Open hernia repair
What is Hernia Surgery?
Hernia repair surgery is a procedure to fix a hernia—a condition where an internal organ or fatty tissue pushes through a weak spot in the surrounding muscle or connective tissue.
Hernias most commonly occur in the abdominal wall, causing a visible bulge and often pain. Surgery is the only definitive treatment to repair the weakened area and prevent serious complications.
Key Facts About Hernia Repair
- It is one of the most common surgical procedures performed worldwide.
- Modern techniques are minimally invasive, using small incisions for less pain and faster recovery.
- Synthetic mesh is often used to reinforce the repair and significantly reduce the risk of the hernia coming back.
- Recovery is usually quick, with many patients returning to light activities within days.
Common Types of Hernia Repair Surgery
Open Hernia Repair
- Procedure: A single, larger incision is made directly over the hernia. The surgeon pushes the protruding tissue back into place and repairs the muscle weakness by sewing it closed, often reinforcing it with a mesh patch.
- Best for: Large or complex hernias, or when minimally invasive surgery is not suitable.
Laparoscopic Hernia Repair
- Procedure: The surgeon makes several small (5-10mm) incisions. A tiny camera (laparoscope) and long, thin instruments are inserted to view and repair the hernia from behind the abdominal wall (preperitoneal space). Mesh is almost always used.
- Benefits: Less post-op pain, smaller scars, faster return to normal activities.
Robotic Hernia Repair
- Procedure: Similar to laparoscopic surgery, but the surgeon controls robotic arms for enhanced 3D visualization, precision, and range of motion. This is especially valuable for complex reconstructions.
- Benefits for Ventral Hernias: Allows surgeons to place mesh and then suture a protective layer of tissue (peritoneum) over it, isolating it from the organs. This reduces pain and eliminates the need for post-op drains.
“Mesh-Free” Hernia Repair (Suture-Only)
- Procedure: For very small hernias with strong surrounding tissue, the defect can be closed with strong sutures alone.
- Consideration: This technique has a higher recurrence rate for most hernias. Mesh provides a reinforcing scaffold that is the modern standard of care for durable repairs.
Common Issues Leading to Hernia Surgery
Hernias develop due to a combination of muscle weakness and strain. Common types and causes include:
- Inguinal Hernia: The most common type, occurring in the groin area. More prevalent in men.
- Incisional Hernia: Develops at the site of a previous surgical incision where the wall has weakened.
- Umbilical Hernia: Occurs near the belly button, common in newborns but can also affect adults.
- Ventral Hernia: Any hernia in the abdominal wall, often related to obesity, pregnancy, or heavy lifting.
- Hiatal Hernia: Part of the stomach pushes up into the chest cavity through the diaphragm (not repaired with the techniques above).
When is Hernia Surgery Required?
Not all hernias need immediate surgery. “Watchful waiting” is sometimes an option for small, asymptomatic hernias. Surgery is typically recommended when:
- The Hernia is Symptomatic: Causing pain, discomfort, or a pulling sensation.
- It is Incarcerated: The protruding tissue becomes stuck and cannot be pushed back in, but is not yet an emergency.
- It Becomes Strangulated (A Surgical Emergency): The blood supply to the herniated tissue is cut off. This causes severe pain, nausea, and requires immediate emergency surgery.
- The Hernia is Growing: Even if not painful, a growing hernia will become more complex to repair.
- Lifestyle Limitation: The hernia prevents you from performing daily activities or work.
Risks and Complications
While safe, all surgeries carry some risk:
- Recurrence: The hernia can come back, though the use of mesh makes this much less likely.
- Seroma: A common, harmless collection of clear fluid under the skin at the repair site. Most resolve on their own.
- Infection: Risk is higher in open repairs than laparoscopic ones.
- Chronic Pain: Rarely, patients can experience persistent nerve pain or discomfort in the area.
- Mesh-Related Issues: Feeling of stiffness or, very rarely, infection or adhesion-related problems. Modern mesh is designed to be well-tolerated.
- Bleeding or Injury: To nearby structures, though this is uncommon.
Recovery and Post-Operative Care
Recovery varies by the type of surgery and the size of the hernia.
- Hospital Stay: Most laparoscopic/robotic repairs are outpatient procedures (go home the same day). Open or complex repairs may require an overnight stay.
- Pain Management: Easily controlled with oral medication. Pain from minimally invasive surgery is typically minimal.
- Activity:
- Walking: Encouraged immediately.
- Driving: Usually okay after 3-5 days, once off narcotic pain meds.
- Work: Desk jobs can often be resumed in a few days. No heavy lifting (>10 lbs) for 4-6 weeks.
- Drains: Sometimes used for large open repairs but are rarely needed with robotic surgery.
Follow-Up Care
- Incision Care: Keep small incisions clean and dry. Steri-strips will fall off on their own.
- Post-Op Visit: Usually scheduled for 2-3 weeks after surgery to check healing.
- Long-Term: For most routine repairs, no long-term follow-up is needed once fully healed.
Frequently Asked Questions (FAQs) About Hernia Surgery
How long does hernia surgery take?
Most routine repairs take between 30 to 60 minutes. Complex or large hernias may take longer.
Is mesh safe?
Yes. The use of synthetic mesh in abdominal wall hernia repair is well-established and safe. It dramatically reduces the chance of the hernia returning. The issues publicized about mesh are related to a specific type used in pelvic organ prolapse surgery, which is completely different.
Will the hernia come back?
Recurrence rates are low, especially with mesh reinforcement (often <5%). Recurrence is more likely with large hernias, smokers, and those with higher BMI.
When can I go back to the gym?
You can resume light cardio (walking, stationary bike) within a week. Avoid heavy lifting and core exercises for at least 4-6 weeks to allow the repair to heal fully.
What is a seroma and is it dangerous?
A seroma is a harmless fluid collection that feels like a soft, water-filled balloon under the incision. It is very common and usually reabsorbs on its own over several weeks.
Laparoscopic vs. Open repair: which is better?
Laparoscopic/robotic repair generally offers less pain, a faster recovery, and smaller scars. However, open repair is still the best option for some complex or recurrent hernias. Your surgeon will recommend the best approach for you.
How will my hernia be repaired if I have multiple abdominal surgeries?
Previous surgery can create scar tissue, making a laparoscopic approach more challenging. In these cases, surgeons may use robotic assistance for better precision or may recommend an open repair.
Do I need to prepare for surgery in any special way?
For laparoscopic surgery, you may be advised to shower with a special antiseptic soap beforehand. If you smoke, stopping before surgery significantly improves healing.
Can a hernia heal on its own?
No. Once a hole in the muscle fascia develops, it cannot close on its own. It will likely get larger over time.
What happens if I don't get surgery?
A small, painless hernia may be monitored. However, there is always a risk it could become incarcerated or strangulated, which is a painful, dangerous emergency requiring immediate surgery.