Hernia surgery is performed to repair a hernia, which occurs when an organ or fatty tissue protrudes through a weak spot or tear in the surrounding muscle or connective tissue.


Hernias commonly occur in the abdominal wall but can also affect other areas of the body. 


Surgery is often recommended for hernias that cause pain, discomfort, or other complications and cannot be managed effectively through non-surgical methods.




Types of Hernia Surgery


Open Hernia Repair

This requires making an incision near the hernia site, pushing the protruding tissue back into place, and reinforcing the weakened area with sutures or mesh. The traditional, open approach to hernia repair remains appropriate in many situations.


Laparoscopic Hernia Repair

Keyhole hernia repair can be used for most types of abdominal hernias such as inguinal hernias or incisional hernias. It requires several small (5-10mm) incisions, inserting a laparoscope with a camera attached, and using specialized instruments to repair the hernia from within the abdomen or between the layers of the abdominal wall (preperitoneal). Mesh may also be used to reinforce the area.


Robotic Hernia Repair

Involves making small incisions and inserting a camera and other instruments. These are then attached to a surgical robot for greater magnification and precision to fix the hernia from the inside. Mesh may also be used to reinforce the area.

Robotic Ventral Hernia repair
Abdominal wall (ventral) hernias can be repaired using the robot. During the procedure, small incisions are made in the abdomen, and the robotic arms are connected to instruments that are inserted through these incisions.


The surgeon controls the robotic arms to repair the hernia from the inside. Hernia contents (typically fat or intestines) are reduced and the defect is closed with sutures. A peritoneal flap is raised for mesh to be placed to reinforce the repair. The peritoneum is then stitched over the mesh so that the mesh is not in contact with the organs.


The robotic approach avoids a large incision and decreases the risk of wound infection. Patients have been shown to have less pain, less scarring and faster recovery both in and out of hospital. Patients also don’t need drains and thus don’t need district nursing input and ongoing community care.


‘Mesh-free’ Hernia Repair

When hernia defects are small and the surrounding tissue of good quality, hernia repairs without mesh provide good, lasting outcomes. However, in many scenarios, there is simply not enough body wall to bring together with stitches alone. 


Hence, a scaffold- mesh- is needed to help heal a hernia. Although the use of mesh in gynaecology surgery has been associated with adverse outcomes, mesh use in abdominal hernias is established and safe. The use of mesh reduces hernia recurrence. Biological mesh can also be used if appropriate to reduce the risk of mesh-related side effects though these are generally rare in hernia surgery.


Recovery and Post-operative Care

After hernia surgery, patients are usually monitored in the hospital for a brief period to ensure there are no immediate complications.


Pain management, antibiotics, and other supportive measures may be provided. Many patients go home on the same day with a few staying overnight or longer.


Patients with large incisional hernias can sometimes go home with a drain to prevent late collection of fluid or infection. Patients are typically encouraged to resume light activities soon after surgery, gradually increasing physical activity over time. Full recovery may take several weeks, and patients are advised to avoid heavy lifting and strenuous activities during the initial healing period.


Risks and Complications

While hernia surgery is generally considered safe, some risks and complications may include infection, bleeding, damage to surrounding structures, altered sensation and recurrence of the hernia.


With larger hernias, the overlying skin and other tissues can be stretched out. After repair, this can lead to a temporary collection of fluid in the area called a seroma. These usually self-resolve but can rarely need drainage.


Follow-Up Care

Regular follow-up visits with a healthcare provider are important after hernia surgery. These visits are essential for monitoring the healing process, ensuring that the incision site is free of infection, and assessing for any signs of hernia recurrence.


Patients may receive specific instructions regarding wound care, pain management, and physical activity restrictions to promote a successful recovery. Compliance with these instructions is crucial for minimizing the risk of complications and promoting the best possible outcome.

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