Hernia Surgery

A hernia is a weakness or defect in the wall of the abdomen. Some are born with this weakness, or it can be caused by the wear and tear of daily living. Although men are more likely to have hernias, they also occur in women and children. In fact, hernias are so common that people of any age can get them. Most hernias aren’t life threatening. But treatment can help eliminate discomfort and prevent complications. 

A hernia will not heal on its own. Surgery is needed to repair the weakness in the abdominal wall. If not treated, a hernia will get larger. It can also lead to serious medical complications. Fortunately, hernia surgery can be done quickly and safely. Different methods are used depending on the location and type of hernia. You can usually go home the same day as surgery. 

The type of hernia you have depends on its location. The most common types of hernias form in the groin. Other types form in the abdomen around the navel or the site of a previous surgery. Hernias can also form on both sides of the body (bilateral hernias), or recur in the same spot (recurrent hernias). In some cases, you can have more than one type at a time.

Surgery

Traditional Surgery: To make a traditional repair, an incision is made over the hernia. The muscle tissue surrounding the weak area is then sewn together to repair the defect. The incision is closed with stitches, staples, surgical tape, or special glue. This method can be used to repair any type of hernia. 

Tension-Free Repairs Using Mesh: Most hernias are treated using “tension-free” repairs. This is surgery that uses special mesh materials to repair the weak area. Unlike traditional repairs, the abdominal muscle isn’t sutured together. Instead, the mesh covers the weak area like a patch. This repairs the defect without “tension” on the muscles. It also makes recovery faster and less painful. The mesh is made of strong, flexible plastic that stays in the body. Over time, nearby tissues grow into the mesh to strengthen the repair. 

The following hernias can be repaired with traditional surgery, or, more often, using the mesh device to make a tension-free repair.

Umbilical hernias form at the navel. They are common in adults and children of both genders. The hernia is often present at birth. Or, it can be caused by abdominal pressure from pregnancy, frequent coughing, being overweight, or other factors. 

Incisional hernias bulge through the scar left by a previous surgical incision. They can occur months or years after the surgery. Over time, incisional hernias can widen and become more difficult to repair. They can also become strangulated and cause serious complications. 

Femoral hernias, a weakness in the femoral canal, are more common in women. This is the opening where large blood vessels and nerves pass between the leg and abdomen. Although these hernias are small, they can trap the intestine and cause serious complications. 

Epigastric hernias form in the upper abdomen at the midline. This is an area where muscle and connective tissue fibers are prone to weakness. 

    The Day of Surgery: At the hospital or surgical center, you will be given an IV to provide fluids and medication. Shortly before surgery, an anesthesiologist will explain the types of anesthesia used to prevent pain during surgery. You will have one or more of the following: 

    • Monitored sedation to make you relaxed and sleepy.
    • Local anesthesia to numb the surgical site. 
    • Regional anesthesia to numb specific area of your body. 
    • General anesthesia to let you sleep during surgery. 

    When the procedure is over, you’ll be taken to the recovery area to rest. Your blood pressure and heart rate will be monitored. You’ll also have a bandage over the surgical site. To help reduce discomfort, you’ll be given pain medications. You may also be given breathing exercises to keep your lungs clear. Later, you’ll be asked to get up and walk. This helps prevent blood clots in the legs. You can go home when your surgeon says you’re ready. 

      Your Recovery: Help make your surgery a success by taking an active role in your recovery. Start by reducing the pain and swelling. Then begin easing back into your routine. For best results, take short walks as soon as you can. This helps prevent blood clots in the legs. It will also help speed healing. Follow your surgeon’s advice about caring for your incision. And be sure to keep appointments for follow-up visits. 

      For the first few days, it’s common for area around the incision to be swollen, discolored, and sore. To help reduce swelling, you can put an ice pack or bag of frozen peas in thin towel. Then place the towel on the swollen area 3 to 5 times a day for 15 to 20 minutes at a time. Take care of the incision as advised by your surgeon. You should also ask your surgeon when it’s okay to start bathing again. In most cases, this a day or two after surgery. 

      If a groin hernia was repaired, you may have swelling that gets worse after a few days. This is because blood and fluids can collect in the groin and genitals. To help reduce swelling, use ice packs. Wearing supportive underwear, such as briefs, can also help reduce discomfort. 

      Manage Pain: You will likely have some pain for the first few days. You may also feel bloated and tired. To help you feel better, your surgeon will prescribe pain medications. Don’t wait for pain to get bad. Take your medications on time as directed. Be aware that some pain medications can cause constipation. So, your surgeon may also suggest a laxative or stool softener. 

      Call your surgeon if you have any of the following:

      • A large amount of swelling or bruising (some testicular swelling and bruising is common)
      • Bleeding 
      • Increasing pain 
      • Fever over 101F
      • Increasing redness or drainage of the incision 
      • Trouble urinating 
      • Nausea or vomiting 

      Children

      Hernias in children are not uncommon. They’re caused by an abdominal wall defect that is present at birth. Most often, the hernia forms in the groin or umbilical area. It can usually be felt as a bulge under the skin. Childhood hernias can be safely repaired using outpatient (same day) surgery. Best of all, most children recover quickly with only minor discomfort. 

        The Day of Surgery: Your child will be given an IV to provide fluids and medications. You’ll then meet the anesthesiologist. He or she will talk with you about the anesthesia used to prevent pain during surgery. The type of surgery your child has depends on the location of the hernia. If your child has a related problem, such as an undescended testicle, it may also be repaired at the same time as the hernia. 

        • Groin Hernia: an incision is made in the lower abdomen. Any protruding tissue is pushed back into place. The hernia sac is then removed and the incision closed with sutures. 
        • Umbilical Hernia: a semicircular incision is made under the navel. Any protruding tissue is pushed back into place and the hernia sac is removed. The abdominal wall is then closed with sutures. 

        Your Child’s Recovery: Your child can likely go home the same day as surgery. Don’t worry if you notice some swelling or bruising. This is normal and should go away in a short time. To help speed recovery, encourage your child to move around. But children should avoid rough play for about a week. After that, it’s okay to let them get back to doing things they enjoy. If you have questions or concerns, be sure to talk with the surgeon during follow-up visits. 

        After surgery, call the surgeon if your child has any of the following: 

        • A large amount of swelling or bruising
        • Fever over 101F
        • Increasing redness or drainage of the incision 
        • Bleeding 
        • Increasing pain 
        • Nausea or vomiting