(Herniorrhaphy; Repair, Hernia)
Definition
Definition
A hernia forms when your abdominal wall weakens, bulges, or tears. The inner lining of the abdomen and small intestine can poke out of this weakened area. A hernia repair is a surgery to push the abdominal material back where it belongs and to repair the abdominal wall.
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Reasons for Procedure
Reasons for Procedure
A hernia repair is done if the hernia is large and causing pain. Some hernias, called strangulated hernia, can cut off blood supply. Strangulated hernias require immediate hernia repair surgery.
Without surgery, the hernia will not heal. The pain and size of the hernia usually increases over time.
Possible Complications
Possible Complications
Complications are rare, but no procedure is completely free of risk. If you are planning to have a hernia repair, your doctor will review a list of possible complications, which may include:
- Damage to neighboring organs or structures (such as, intestine or bladder)
- Infection
- Bleeding
- Scarring
- Reaction to anesthesia
Factors that may increase the risk of complications include:
What to Expect
What to Expect
Prior to Procedure
Your doctor may do the following:
- Physical exam
- Blood tests
- Urine tests
- Electrocardiogram (EKG)—A test that records the heart’s activity by measuring electrical currents through the heart muscle.
- Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
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.
- The night before, eat a light meal. Do not eat or drink anything after midnight.
- Wear comfortable clothing.
Anesthesia
Depending on the type of repair, you may receive:
- Local anesthesia—the area will be numbed
- General anesthesia—you will be asleep during the procedure
Description of Procedure
There are two main types of surgeries. A conventional surgery or laparoscopic surgery. Conventional surgery uses a large incision so that the doctor can directly access the area. Laparoscopic surgery uses smaller incisions and special surgical tools. You and your doctor will discuss the risks and benefits of each surgery to determine which may be best for you. Factors like your overall health, location of hernia, and complications will play a role in the decision.
Conventional Hernia Repair
An incision is made over the hernia site. The hernia will be moved back into the abdominal cavity, or the sac may be removed. In the case of hiatal hernia, the stomach is moved from the chest cavity back down to the abdominal cavity.
For some, the weakened muscles that allowed the hernia to develop are sewn together. If the weakened area is large or in the groin, a piece of mesh will be placed over the area to create a new wall. If mesh is used, the muscle is not sewn together. The incision will be closed with stitches or staples.
Laparoscopic Hernia Repair
Small incisions will be made around the hernia. Special surgical tools will be placed through these incisions. A small camera will be passed through an incision so that the doctor can see inside the abdomen. Other small instruments will be used to complete the repair.
After the procedure, the incisions will be closed with stitches or staples. A sterile dressing will be applied.
Immediately After Procedure
You will be taken to a recovery area. Fluids and pain medications will be delivered through an IV. If there are no problems, you will be moved to a hospital room to recover.
How Long Will It Take?
Less than 2 hours
Will It Hurt?
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Post-procedure Care
At home, slowly return to to normal activity and diet. Your doctor may advise pain medications. You will have to restrict activities during your recovery. Avoid straining and heavy lifting until your doctor says it is okay to do so. Follow wound care instructions to avoid infection. The recovery time will be shorter for laparoscopic surgery.
There is some risk that the hernia could return. To reduce your risk:
- Maintain a healthy weight.
- Eat a healthful diet.
- Strengthen your abdominal muscles.
- Treat chronic constipation, allergies, or chronic cough.
Call Your Doctor
Call Your Doctor
It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- Persistent nausea and/or vomiting
- Pain that you cannot control with the medications you’ve been 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 medical help right away.
RESOURCES:
National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/
CANADIAN RESOURCES:
Health Canada http://www.hc-sc.gc.ca
References:
http://www.ebscohost.com/dynamed
Accessed January 30, 2015.
Inguinal hernia. Hopkins Medicine website. Available at:
http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/digestive_disorders/inguinal_hernia_85,p00387
Accessed January 30, 2015.
Laparoscopic surgery for hernia repair. Cleveland Clinic website. Available at:
http://my.clevelandclinic.org/health/treatments_and_procedures/laparoscopic-surgery/hic_Laparoscopic_Surgery_for_Hernia_Repair
Updated February 27, 2013. Accessed January 30, 2015.
Last Updated: 5/1/2014