Hernia Repair
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Hernia Repair

(Herniorrhaphy; Repair, Hernia)

En Español (Spanish Version)

Click here to view an animated version of this procedure.

Definition

This operation treats hernias. A hernia forms when the abdominal wall weakens, bulges, or tears. This causes the inner lining of the abdomen to protrude and form a sac.

Hernias can occur in the following areas:

  • Groin (called inguinal hernia), the most common site
  • Navel
  • Site of a surgical incision
  • Upper-middle abdomen
  • Between the abdomen and thigh
  • Where the esophagus joins the stomach (called hiatal hernia)
  • Where any part of the body abnormally protrudes into any other area

Inguinal Hernias

Nucleus factsheet image

© 2008 Nucleus Medical Art, Inc.

Parts of the Body Involved

The most common places are:

  • Groin
  • Abdomen and abdominal cavity

Reasons for Procedure

This is done to repair the hernia. If a hernia is “strangulated” (pinched so the blood supply is cut off), emergency surgery is done. If it is not strangulated, you can choose when to have the surgery. Without surgery, the hernia will not heal. The pain and size of the hernia usually increases over time.

Risk Factors for Complications During the Procedure

Risk factors include:

  • Having neurological, cardiovascular, or respiratory conditions
  • Age: older than 70 years
  • Obesity
  • Smoking
  • An active infection

What to Expect

Prior to Procedure

Your doctor will likely do the following:

  • Physical exam
  • Blood tests
  • Urine tests
  • Electrocardiogram (EKG, ECG)—a test that records the heart’s activity by measuring electrical currents through the heart muscle
  • Instruct you to stop some medications before surgery (eg, aspirin) to avoid interactions with anesthetics and abnormal bleeding
  • Ask if you are taking medications for your heart or for diabetes

On the days before and the day of your procedure, your doctor may recommend that you:

  • Follow a special diet
  • Take antibiotics
  • Shower the night before using antibacterial soap
  • Arrange for someone to drive you home and to help you at home
  • On the night before, eat a light meal and do not eat or drink anything after midnight
  • Wear comfortable clothing

Anesthesia

Description of the Procedure

Conventional Hernia Repair

An incision is made over the site. The surgeon moves the hernia back into the abdominal cavity and may remove the sac. The muscles around the hernia are sewn together to repair the hole or weakness. If the hernia is large or in the groin, a piece of mesh is inserted. This is to do the repair without sewing together the muscle.

Laparoscopic Hernia Repair

Several small incisions are made in the abdominal cavity. The surgeon inserts a laparoscope, which has a tiny camera and a light, and views the hernia on a TV. The hernia is repaired using tiny instruments that have been inserted through the other incisions.

After the procedure, the incisions are closed with stitches or staples. A sterile dressing is applied.

After Procedure

In the recovery room, you will receive fluids and pain medications through an intravenous (IV) line.

How Long Will It Take?

  • Less than 2 hours

Will It Hurt?

Anesthesia prevents pain during surgery. You may feel pain during recovery, but taking pain medication will help.

Possible Complications

  • Damage to neighboring organs or structures (eg, intestine or bladder)
  • Infection
  • Bleeding
  • Scarring
  • Pneumonia and other risks of general anesthesia

Average Hospital Stay

  • None

Postoperative Care

  • Ask your doctor about your diet and activities.
  • During the first few days, slowly return to your normal routine.
  • Take pain medication as needed.
  • Ask your doctor certain activities (eg, driving, sexual activity). You may need to wait 1-2 weeks.
  • Avoid excess strain (eg, vigorous exercise and lifting) for 6-8 weeks.

The recovery time will be shorter for laparoscopic surgery.

Outcome

The outcome depends on your health, age, type of hernia, and strength of your abdominal tissue. There is some risk that the hernia could return. You can reduce this risk by:

Call Your Doctor If Any of the Following Occurs

After you leave the hospital, call your doctor if any of the following occurs:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
  • Pain, burning, urgency, frequency of urination, or persistent bleeding in the urine
  • Excessive tenderness or swelling
  • Severe or increasing pain

RESOURCES:

Hernia Information
http://www.hernia.org/

National Digestive Diseases Information Clearinghouse
http://digestive.niddk.nih.gov/

CANADIAN RESOURCES:

BC Health Guide
http://www.bchealthguide.org/

The Canadian Association of Gastroenterology
http://www.cag-acg.org/default.aspx/

References:

The causes and surgical treatment of abdominal hernia. American Medical Association website. Available at: http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZESG4TWAC&sub_cat=195 . Accessed November 10, 2005.

Hernia. Cleveland Clinic website. Available at: http://www.clevelandclinic.org/health/health-info/docs/3600/3619.asp. Updated June 2008. Accessed June 9, 2008.

Hernia repair. American College of Surgeons website. Available at: http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZBTQW1RWC&sub_cat=195 . Accessed November 10, 2005.



Last reviewed January 2008 by Ronald Nath, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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