Hernia Repair

General Information

A hernia is a “defect” or weakness in the abdominal wall. There are several locations and types of hernias, all requiring different types of surgery. The bulge associated with most hernias is not the hernia itself, but the hernia contents protruding through the defect. The common areas where hernias occur are in the groin (inguinal or femoral), belly button (umbilical), above or below the belly button (ventral), and the site of a previous operation (incisional). Hernias are repaired to prevent the hernia from becoming larger and uncomfortable and to prevent the contents from becoming entrapped (incarcerated) or strangulated.

Pre-Op Prep

Labs and other studies are ordered prior to surgery based on the patient’s age and the presence of any existing medical problems. Patients should not eat or drink anything after midnight the night before surgery. Drugs such as aspirin, blood thinners (Coumadin, warfarin, Pradaxa, Xarelto, Eliquis), Plavix, and anti-inflammatory medications (Ibuprofen, Naproxen) should be stopped before surgery. Ask your doctor how long you should be off your medication. A bowel prep may be given to patients with incisional or ventral hernias.

Open Inguinal / Femoral Hernias

Indications:

Except in rare circumstances, most groin hernias require repair.

Pre-Operative Evaluation:

A history and physical examination confirm the presence of a hernia.

Procedure:

Depending on whether you and your surgeon decide to pursue a laparoscopic or open repair, the procedures(s) are somewhat different. A 2-3 inch incision is made in the groin. The contents of the hernia are returned to the abdomen and the hernia defect is repaired using a synthetic mesh patch.

Length of Stay:

Outpatient.

Recovery:

1–2 weeks.

Laparoscopic Inguinal Hernia Repair

Indications:

Groin hernias can also be repaired laparoscopically.

Pre-Operative Evaluation:

A history and physical examination confirm the presence of a hernia.

Procedure:

The defect(s) are repaired using a synthetic mesh that covers all of the defects from the “inside” behind the muscles of the abdominal wall. The mesh material is fixed to the abdominal wall in a way that eliminates the defects.

Length of Stay:

This procedure is usually done as an outpatient, with an overnight stay in the hospital occasionally necessary for ventral and incisional hernias.

Recovery:

Appropriately selected patients may have less pain and quicker recovery when compared to the open procedures.

Open Incisional And Ventral Hernias

Indications:

These are hernias that develop at previous incision sites or on the abdominal wall (including the “belly button”). Most of these hernias require repair.

Pre-Operative Evaluation:

A history and physical examination confirm the presence of a hernia.

Procedure:

An incision is made over the hernia. The contents are returned to the abdomen and a synthetic mesh patch is usually used to complete repair.

Length of Stay:

Outpatient except in the case of large hernias which might require brief hospitalization.

Recovery:

1–2 weeks. No lifting over 5-10 pounds for six weeks.

Laparoscopic Ventral / Incisional Hernia Repair

Indications:

Ventral and incisional hernias can be repaired laparoscopically.

Pre-Operative Evaluation:

A history and physical examination confirm the presence of a hernia.

Procedure:

The defect(s) are repaired using a synthetic mesh that covers all of the defects from the “inside” behind the muscles of the abdominal wall. The mesh material is fixed to the abdominal wall in a way that eliminates the defects.

Length of Stay:

This procedure is usually done as an outpatient, with an overnight stay in the hospital occasionally necessary for ventral and incisional hernias.

Recovery:

Appropriately selected patients may have less pain and quicker recovery when compared to the open procedures.