Hernia Repair

A hernia is a place where part of an organ pushes through a weak area of the muscle that should hold it in place, affecting both children and adults. There are different types of hernias, depending on what part of the body they occur:

• Inguinal hernia. With an inguinal hernia, intestines or fatty tissue push through a weak spot in the groin, where the upper leg meets the abdomen.
• Umbilical hernia. An umbilical hernia is a bulge in the muscle of the belly, at the belly button.
• Hiatal hernia. Hiatal hernias happen when the top of the stomach bulges through an opening in the diaphragm (the large muscle between the stomach and chest that helps you breathe).

Not all hernias need to be repaired, especially in infants or toddlers where their umbilical hernia may close on its own. However, in many cases surgery may be required to repair the weakened area. Your doctor may recommend surgical hernia repair:

• If the hernia is painful.
• If the hernia is strangulated. This means the tissue has become trapped or twisted and may not be getting enough blood. A strangulated hernia is dangerous.
• To prevent the hernia from becoming painful or strangulated.

If your hernia does not require surgery right away, your surgeon may recommend:

• Wearing a special device called a truss to hold tissues in place
• Watching and waiting

Hernia Repair Surgery

Surgery to repair hernias are common and usually very successful. There are two types of surgery:

• In laparoscopic surgery, the surgeon makes two or three very small incisions (cuts) near the hernia and reaches it with long, thin tools. A laparoscope (a tiny camera) shows the hernia on a screen.
• In open surgery, the surgeon makes one longer incision over the hernia and opens the skin.

Risks and possible problems of hernia surgery are rare but can include:

• Injury to veins, nerves, or bladder
• Blockage in digestive tract
• Need for another surgery
• Reactions to anesthesia such as allergy, nausea, vomiting, sore throat, and headache
• Reactions at the site of the surgery including infection, excess bleeding, and blood clots

Surgery to repair a hernia can:

• Eliminate or reduce pain from the hernia
• Prevent or repair strangulation

Surgery usually lasts about an hour. These are things that will happen during that time:

• Anesthesia. You will be given anesthesia medicine so you don’t feel any pain. This may be general anesthesia, which makes you sleep and prevents you from feeling or remembering the surgery. Or, you may have a regional or a local anesthesia. These prevent feeling in the area of the surgery. The anesthesia you receive usually depends on the type of surgery you are having.
• Repairs. The surgeon will make one or more incisions to reach the hernia. In most cases, the tissue can be pushed back into place. Then, the surgeon will repair the weak muscle layer. A piece of mesh material may be sewn over the weak area to strengthen it.
• Other steps. If the hernia was strangulated and tissue was damaged, your surgeon may also need to remove or repair that tissue.
• Closing the incisions. The surgeon will close your incisions with stitches or staples. They will be removed when your incisions have healed.

What happens after surgery?

You will remain in the hospital for most of the day.

• Monitoring your recovery. You will be transferred to a recovery area where you will be watched until the anesthesia wears off.
• Activity. Many doctors recommend their patients get up and walk around the day of surgery.
• Going home. Most patients go home the day of surgery. You will be able to go home as soon as your surgeon feels it is safe for you.

How do I care for myself at home?

These are things you can do to help your recovery:

• Manage your pain. Your doctor will recommend a pain medicine for you. Be sure to take it exactly as instructed. Managing your pain well will help you recover better.
• Move around. Get up and move around as you would normally, but be careful to protect your surgery area from being bumped. Avoid heavy lifting.
• Keep your skin clean. You can shower, but don’t take a bath for at least five days.

Return to work when it’s recommended by your doctor. How soon you can return to work depends on your condition, and on what type of work you do. Talk with your doctor about your job.

Complete recovery should take about two to four weeks.

How do I keep from having another hernia?

Here are things you can do to help prevent another hernia:

• Avoid heavy lifting, bending, or twisting, especially for the first few weeks after surgery.
• Stay at a healthy weight. Extra weight puts pressure on your abdomen (belly). If you need to lose weight, do it slowly and avoid crash diets. Eat a healthy diet to maintain muscle strength.
• Try not to cough a lot. Coughing puts pressure on your abdomen. If you smoke, now is a good time to quit.
• Try not to push hard when you go to the bathroom. If you’re constipated, ask your doctor if you should take a stool softener.