Lahey Health is now part of Beth Israel Lahey Health

by McCoy K
(Herniorrhaphy; Repair, Hernia)

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Definition

A weak area of belly wall can let tissue poke out of the belly. This is called a hernia. A hernia repair is a surgery to push the tissue back where it belongs. The wall of the belly will also be fixed.

Abdominal Hernia
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Reasons for Procedure

Large hernias and those that cause pain will need repair. The hernia will not heal without surgery. The pain and size of the hernia can increase over time.

Tissue that pokes through the hole can become trapped. If the blood flow is cut off to the tissue it is called a strangulated hernias. This is an emergency. Immediate surgery will be needed.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Damage to nearby organs such as the intestines or bladder
  • Infection
  • Bleeding
  • Scarring
  • Reaction to anesthesia
  • Chronic pain from nerve damage

Factors that may increase the risk of complications include:

  • Having neurological, heart, or lung conditions
  • Age: older than 70 years
  • Obesity
  • Smoking—can slow healing
  • Active infection

What to Expect

Prior to Procedure

The doctor will review tests that have been done. Your overall health will be checked. You may need a physical exam if it has been a long time since your last exam.

Talk to your doctor about any medicine or supplement that you take. Some may need to be stopped up to 1 week before the procedure.

Your doctor may recommend that you:

  • Shower the night before, using antibacterial soap.
  • The night before, eat a light meal. Do not eat or drink anything after midnight.
  • Wear comfortable clothing to surgery.
  • Arrange for someone to drive you home and to help you at home.
  • Stop smoking before the procedure.

Anesthesia

There are different types of hernia repair. They may use different types of anesthesia. Options include one of the following:

  • Local anesthesia—the area will be numbed. You will be awake but given medicine to help you relax.
  • Spinal anesthesia—lower half of your body will be numb. Medicine is passed into fluid around spine.
  • General anesthesia —you will be asleep.

Description of Procedure

There are two main types of surgeries:

  • Conventional (open) surgery—cuts are made in the belly. The surgeon will be able to see the area directly.
  • Laparoscopic surgery—smaller cuts are needed. Special tools will be passed through these cuts.

You and your doctor will talk about your options. Laparoscopic tends to have a faster recovery. However, it is not appropriate for everyone.

Conventional Hernia Repair

An cut is made over the site. The tissue will be moved back into place. The belly wall will be repaired. Steps may include:

  • Weaker muscles may be sewn together.
  • A large opening or one in the groin may need mesh support. The mesh will help to create a new wall. If mesh is used, the muscle is not sewn together.

The cut will be closed with stitches or staples.

Laparoscopic Hernia Repair

Small cuts will be made around the site. A tube will be passed through a cut. It will push gas into the belly. This will make it easier for the surgeon to work. A camera will allow them to see inside the belly. Other tools will be passed through the cuts. They will be used to repair the area. Tissue will be pushed back into place. The belly wall will be closed.

The cuts will be closed with stitches or staples. A dressing will be placed over the cuts.

Immediately After Procedure

A care team will watch over your vital signs until you wake. Fluids and pain medicine will be given through an IV.

How Long Will It Take?

Less than 2 hours

Will It Hurt?

Anesthesia will prevent pain during surgery. You will be sore for at least 24 to 48 hours after surgery. Medicine will help to manage pain.

Post-procedure Care

You will be encouraged to walk the day after surgery. It may take about a week to return to normal activity after laparoscopic surgery. Open surgery may take a bit longer.

Some activity will need to be avoided during recovery. This includes straining and heavy lifting.

Call Your Doctor

Call your doctor if any of these occur:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
  • Persistent nausea or vomiting
  • Pain that you cannot control with the medications you were given
  • Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
  • Excessive tenderness or swelling
  • Cough, shortness of breath, or chest pain

If you think you have an emergency, call for emergency medical services right away.

RESOURCES

American Hernia Society  https://americanherniasociety.org 

National Institute of Diabetes and Digestive and Kidney Diseases  https://www.niddk.nih.gov 

CANADIAN RESOURCES

Canadian Association of Gastroenterology  https://www.cag-acg.org 

Health Canada  https://www.canada.ca 

References

Groin hernia in adults and adolescents. EBSCO DynaMed Plus website. Available at:  https://www.dynamed.com/topics/dmp~AN~T113880/Groin-hernia-in-adults-and-adolescents  . Updated March 14, 2018. Accessed March 26, 2018.

Inguinal repair surgery information. Society of American Gastrointestinal and Endoscopic Surgeons website. Available at: https://www.sages.org/publications/patient-information/patient-information-for-laparoscopic-inguinal-hernia-repair-from-sages/. Updated March 2015. Accessed January 7, 2019.

Laparoscopic surgery for hernia repair. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/treatments/6905-laparoscopic-surgery-for-hernia-repair. Updated March 1, 2017. Accessed March 26, 2018.

Revision Information

  • Reviewer: EBSCO Medical Review Board Marcin Chwistek, MD
  • Review Date: 03/2018
  • Update Date: 01/07/2019