Hernia repair is one of the more common forms of surgeries, with over 700,000 groin or inguinal hernia operations performed in the United States each year. In many cases, hernia repair surgeries can be performed on an outpatient basis through minimally invasive procedures.
Both men and women can get hernias, and it is important to understand what a hernia is, as well as the repair options available.
A good analogy of a hernia is that of an inner tube pushing through the surface of a damaged tire. A hernia occurs when the layers of the abdominal muscle weaken and bulge through the abdominal wall. In turn, this can allow a loop of intestine or abdominal tissue to push into the sac, causing discomfort, severe pain, or other serious problems that may require emergency surgery. It is important to note that a hernia does not get better with time and can't be resolved through exercise and/or physical therapy.
Hernias most commonly occur in the inguinal (groin), umbilical (belly button), and incisional (site of a previous surgery) area. They are generally easy to recognize, either because of a bulge under the skin, or when you feel discomfort while coughing, lifting heavy objects, or even after prolonged standing or sitting. You may feel it as a sharp pain or as a dull ache that worsens toward the end of the day.
While hernia repair can involve open surgery, minimally-invasive repair is often the best option because:
For some patients, minimally-invasive outpatient hernia repair surgeries are not an option because the patient has significant scar tissue from a previous abdominal surgery; the patient is obese; there's been a previous infection at the site of the hernia; the surgeon has difficulty in seeing the patient's organs with the laparoscope; or when the patient has bleeding problems during the surgery.
What Do Hernia Repair Surgeries Involve?
The three main approaches to inguinal or femoral hernia operations are:
Laparoscopic hernia repair involves fixing tears in the abdominal walls using small incisions, a laparoscope (a tube with a camera/telescope at the end that allows the surgeon to examine the injury and procedure on a TV monitor), as well as a mesh patch.
The patient is first given an anesthetic and will remain unconscious during the procedure. They will feel no pain during the operation. The surgeon then creates a space between the wall of the abdomen and the surrounding organs by using carbon dioxide gas. Three small incisions are then made in the skin of the abdomen to allow the surgeon to move the laparoscope and other instruments through tubes that also have been inserted in the incisions.
The hernia is pushed back into place with a small piece of surgical mesh. The mesh is fastened into place by surgical sutures or staples, and will help prevent hernias from re-occurring in the same area. Immediate recovery time after this type of surgery is typically only long enough for the anesthesia to wear off. Patients are advised against driving themselves home because of the effects of the medication/anesthesia.
Again, most patients are sent home the same day of having minimally-invasive surgery. Recovery time - and when you can resume normal activities - depends on the severity and type of hernia you have had repaired. Your doctor will provide specific instructions about activities such as driving, showering, lifting, etc.
A single long incision is made in the groin during open hernia repair surgeries. The bulge is pushed back into place if it is in abdominal wall. If it is in the groin area, it is either tied off and removed or pushed back into place.
Open hernia repair surgery usually involves sewing the edges of the healthy muscle tissue back together, or by using mesh patches. The approach depends on both the surgeon's preference and the area of the muscle wall that needs repair.
Patients who have had open hernia repair surgery are usually able to go home the same day. Recovery time is about three weeks, when most patients can resume light activity. It is advised that patients should wait about six weeks before resuming strenuous exercise and/or activity.
This type of hernia repair surgery is common in children, usually because a hernia at birth pushes the belly button outward. In infants, the hernia usually shrinks on itself and surgery is not needed, but surgery may be performed if the hernia becomes stuck and is painful.
