What to Expect From Hernia Repair Surgery (2024)

A hernia is when an organ or tissue protrudes through a weak area of muscle. This is most common in the abdomen. Hernia repair surgery may be called a hernioplasty or herniorrhaphy. During this surgery, the displaced tissue is returned back into the body and the weak spot is stitched or patched up.

Hernia repair surgery is common. It is generally very safe and effective. If you or a loved one are considering this surgery, though, it is important to understand its potential risks and the recovery process.

This article looks at hernia repair surgery and its purpose. It also discusses how to prepare for surgery, what the risks are, and what you should expect while you recover.

What Is Hernia Repair Surgery?

Hernia repair surgery is performed by a general surgeon. It is usually done in a hospital or an outpatient surgical center. An outpatient surgical center is a facility that does not require an overnight stay, so you won't have to stay long after hernia surgery unless there are complications.

The surgery may be done in adults and children. It usually takes less than an hour or two.

Hernia repair surgery is done with anesthesia. The type you receive depends on the surgical technique. It may also depend on if the surgery is an emergency or not.

The three types of anesthesia that you may receive include:

• General anesthesia: This puts you in a sleep-like state.
• Regional anesthesia: This type is given through the spinal cord. It numbs a large part of your body.
• Local anesthesia with sedation: This numbs a smaller part of your body. The sedation relaxes you and may or may not make you fall asleep.

Surgical Techniques

Hernias are repaired with one of three types of surgery:

• Open surgery
• Laparoscopic surgery
• Minimally invasive robotic surgery

The technique used is based on several variables. These may include:

• The size and location of the hernia
• The patient's age
• The patient's overall health

During open surgery, the surgeon makes a cut called an incision near the hernia. The bulging tissue is returned back into the body through the incision.

The weak muscle that allowed the hernia to occur is then repaired. It may be stitched back together or, more commonly, patched with a synthetic material called mesh.

During laparoscopic surgery, multiple tiny incisions are made around the hernia. Long, thin surgical tools are inserted through these incisions.

One of these tools has a camera attached to it. The camera projects images onto a TV screen. This lets the surgeon view the inside of the body. Other tools are used to repair the hernia in the same way as with open surgery.

Robotic surgery also involves a camera and the use of very small surgical tools attached to robotic arms.A specially-trained surgeon controls the robotic arms from a viewing screen, which is usually situated in the same room as the operating table.

Open surgery is a more traditional way to repair a hernia. Laparoscopic surgery is generally less painful and often lets patients recover faster.

Contraindications

There are no absolute contraindications to undergoing hernia repair surgery. This means there are no medical conditions that will exclude you from being able to have hernia surgery.

There may be relative contraindications. These are circumstances that make extra preparation necessary before you can have the surgery. These include:

• A bleeding disorder
• Obesity
• Being a current tobacco user
• A history of blood clots

Purposes of Hernia Surgery

Most hernias occur within the abdominal wall. With these hernias, there is a weakness or tear in the outer abdominal muscles. These muscles normally keep organs or tissues, like the intestines, inside.

In an inguinal hernia, the intestines or fatty tissue bulges through the abdominal muscles in the groin area. About 75% of all hernias are inguinal. These are most common in biological males.

Another type of abdominal wall hernia is a femoral hernia. These occur a bit lower in the groin than inguinal hernias. They are more common in biological females, and carry higher risks if not repaired.

Other types of abdominal wall hernias include:

• Umbilical hernia, a hernia near the belly button that's typically not serious. It is most common in newborns and usually closes on its own. These hernias are more concerning in adults.
• Epigastric hernia, a hernia that requires surgery but isn't usually an emergency
• Incisional hernia, one that develops after abdominal surgery and often needs further repair

Reducible Hernia

A reducible hernia is one that bulges with pressure. This might happen when you're lifting something heavy. It might also happen when you're straining to have a bowel movement.

Reducible hernias return inside the body when the pressure is gone. You may also be able to push them back with gentle pressure from the outside.

These hernias are not considered an emergency, but still require a surgical repair.

Incarcerated Hernia

An incarcerated hernia remains in the "out" position. It can't be pushed back.

These hernias can become strangulated. This means the bulging tissue loses blood flow. This can be life-threatening and requires emergency surgery.

Irreducible hernias can lead to permanent damage. For example, 15% of boys with an irreducible hernia will experience testicular damage and atrophy.

In certain cases, watchful waiting may be recommended. This means your doctor may want to monitor your condition for a while before making a decision about surgery. For example:

• You may have an inguinal hernia that has no symptoms and isn't getting bigger.
• You may have a small, umbilical hernia that has no symptoms. This is a hernia that appears near the belly button. These types of hernias usually aren't serious.
• You may have a sliding hiatal hernia but no reflux disease. This is when your stomach and part of your esophagus slide into your chest through a hole in your diaphragm called the esophageal hiatus. This is the most common type of hiatal hernia. It is not usually dangerous.

Preparing for Hernia Surgery

Your surgeon will give you instructions on how to prepare for your surgery.

These instructions may include:

• Wear comfortable, loose-fitting clothing on the day of your surgery.
• Stop taking certain medications for a period of time before surgery. For example, you should avoid taking aspirin or non-steroidal anti-inflammatory medications (NSAIDs) a week before surgery.
• Stop eating for a period of time prior to surgery. This depends on the surgical technique and type of anesthesia.
• Arrange for someone to drive you home after the surgery.
• Pack personal items if a hospital stay is needed. This is not typical.

What to Expect on the Day of Surgery

What happens the day of your surgery will depend on certain factors. The steps will vary depending on the type of surgery you will have and which anesthesia you will receive.

If you are having laparoscopic surgery, you can expect the following steps:

• After you arrive you will change into a gown. Members of your surgical team will meet with you to briefly review the surgery.
• You will be taken into the operating room. You will be given medication to put you into a sleep-like state.
• While asleep, the surgeon will inflate your abdomen with air. This makes it easier for the surgeon to see your internal organs and tissues.
• A small incision will be made at your navel. The surgeon will insert a laparoscope, a long, thin surgical tool with a camera attached to it.
• The camera will project images onto a TV screen. This lets the surgeon see what is happening inside your body.
• Additional small incisions will then be made. Other surgical tools will be inserted through these incisions.
• The surgeon will use the surgical tools to return the bulging tissue back into its place.
• The surgeon will then stitch or patch the weakness in the abdominal wall.
• The surgeon will then deflate your abdomen. The small incision sites will be closed with stitches or surgical tape.

After the surgery, you will be moved to a recovery room. You will spend a few hours there while the anesthesia wears off. When symptoms like pain are under control, you will be able to go home.

Recovery From Hernia Surgery

Recovery time for hernia repair surgery varies depending on what kind of surgery you had. For laparoscopic surgery, it's typically about one to two weeks. For open repair surgery, it's usually about three weeks.

Make sure to follow your surgeon's post-operative instructions. This will help optimize healing and prevent complications. These instructions may include:

• Use an ice pack or cold compress every couple of hours for 15 minutes. This will help to reduce swelling. Don't put the ice pack directly on your skin.
• Take Tylenol (acetaminophen) to control pain. If your pain is more significant, you may be prescribed an opioid. Take as directed.
• Get up and walk around five to six times per day. This will help prevent blood clots.
• Wash your hands before and after touching your incisions. This helps to prevent infection.
• If you had laparoscopic surgery, your surgeon will advise you on how long to avoid strenuous exercise.

Outcomes and Long-Term Care

Hernias will not heal or resolve on their own. The main benefit of surgery is that, in most cases, it fixes the problem. This means that after you recover, you should be able to return to your normal routine and daily life. You should not have pain, discomfort, or a visible bulge.

In most cases, the long-term prognosis for people who have hernia surgeries is good. Inguinal hernia repairs are generally uncomplicated, although about 10% of people will experience chronic pain and there may be recurrence of the hernia.

About one in six people will have a hernia recurrence after certain abdominal wall repairs, with some variation based on the technique used. There are few short-term complications with incisional hernia repair, although less is known about the long-term impacts.

In the long term, your surgeon will want you to stay healthy. If you have any persistent symptoms, especially pain, let your surgeon know. If you are obese, your surgeon may recommend losing weight to prevent a recurrence.

Potential Risks of Hernia Repair Surgery

The main risks of hernia repair surgery include:

• Bleeding or hematoma. This is when blood collects under the surgical site.
• Seroma, or fluid collection under the surgical site
• Infection, potentially of the surgical site or the surgical mesh used for repair
• Chronic postoperative pain
• Bowel or urination issues, such as constipation or trouble urinating
• Nerve or tissue injury or damage
• Hernia recurrence

Summary

A hernia is when tissue or an organ bulges through a weak area of muscle. Hernia repair is a surgery that can correct this problem. Hernia repair surgery is more urgent when the hernia is incarcerated or permanently in the out position. Surgery can prevent the hernia from becoming strangulated.

Some hernias may not require surgery, at least initially. Your healthcare provider may recommend watchful waiting instead.

Follow your healthcare provider's instructions as you navigate surgery preparation and recovery. Be sure to contact your provider if you have complications, including signs of infection or persistent pain.

A Word From Verywell

Hernia repair surgery can be done with two different techniques, and open procedures also allow for a few anesthesia options. If hernia repair surgery is right for you, your surgeon will be your primary source of information about your options and the best approach.