A hernia occurs when an organ or tissue protrudes through a weak muscular region within the body, usually through the abdominal wall. Hernia repair surgery, also called herniorrhaphy or hernioplasty, involves bringing displaced tissue back into the body and suturing or patching a weak spot.
Although hernia repair is common and generally very safe and effective, it is important to be aware of the potential risks and the recovery process if you or your loved one are considering it.
What is hernia repair surgery?
Hernia repair surgery is performed by a general surgeon in an outpatient surgery center or hospital. The surgery can be done in both adults and children and usually takes less than an hour or two .
Depending on several factors, such as the surgical technique used to repair the hernia and whether the surgery is elective or emergency, you may be assigned one of the following three types of anesthesia:
- General anesthesia
- Regional (spinal) anesthesia
- Local anesthesia with sedation.
Hernias are repaired by open surgery or laparoscopy. The technique used depends on several variables such as the size and location of the hernia, the age of the patient and their general health.
- Open surgery: The surgeon makes an incision (incision) near the hernia and returns the bulging tissue to the body. The weakened muscle that caused the hernia is sutured or, more often, overlaid with a synthetic material called mesh.
- Laparoscopic surgery : Multiple small incisions are made around the hernia. to be able to insert long and thin surgical instruments. A camera is connected to an instrument, so the surgeon can see the images that are projected on the television screen. The instruments are then used to repair the hernia in the same way as in open surgery.
While open surgery is the traditional way to repair a hernia, laparoscopic surgery often allows patients to recover faster and causes less pain. However , laparoscopic surgery requires the patient to undergo general anesthesia, while traditional hernia repair can be performed under general anesthesia. , regional or local anesthesia.
There are no absolute contraindications to hernia repair. Relative contraindications or circumstances in which patients may require additional preparation before surgery include:
Purpose of hernia repair surgery.
The vast majority of hernias occur in the abdominal wall. With hernias of the abdominal wall, there is a weakness or rupture of the external abdominal muscles, which generally contain various organs or tissues within them, such as the intestines.
For example, with an inguinal hernia (which accounts for 75% of all hernias and is more common in men), the intestines or adipose tissue protrudes due to the weakness of the abdominal muscles located in the groin area .
Femoral hernia is another type of abdominal wall hernia. More common in women, it is found slightly lower in the groin than inguinal hernias.
Other types of abdominal hernias include:
A hernia that protrudes due to pressure in the abdomen (for example, by lifting something heavy or straining to defecate), but returns to the inside of the body when the pressure disappears or with slight pressure from the outside, is called a contractive hernia . . These hernias are not considered serious or serious.
Hernias that remain pinched in the outward position and cannot be pushed back are considered pinched . When a hernia is pinched, an emergency can occur if it is strangled, which means that the bulging and pinched tissue loses blood flow. This can be life-threatening and requires urgent surgery.
To improve symptoms and prevent side effects like a pinched hernia, surgeons recommend routine surgery for most hernias .
However, in certain cases, watchful waiting instead of surgery may be reasonable. For instance:
- Male patient with an asymptomatic inguinal hernia (not growing in size) who wishes to avoid surgery.
- Patient with a small asymptomatic umbilical hernia.
- Patient with a sliding hiatal hernia (type 1) without reflux .
How to prepare
Once you have scheduled your hernia surgery (assuming it is planned), your surgeon will give you instructions on how to prepare for the surgery .
These instructions may include:
- Wear comfortable, loose-fitting clothing on the day of surgery.
- Stop taking certain medications before your surgery; for example, aspirin or non-steroidal anti -inflammatory drugs (NSAIDs) one week before surgery.
- Stop eating before surgery (it depends on the surgical technique and the type of anesthesia used).
- Arrange for someone to drive you home after the procedure.
- Collect your personal belongings if hospitalization is required (this is not typical).
What to Expect the Day of Surgery
The length of your operating day will depend on factors such as the type of surgery you will undergo (open or laparoscopic) and the anesthesia you receive .
For laparoscopic hernia repair, you can expect the following steps:
- Upon arrival, you will change into a gown and your surgical team and anesthetists will meet with you to briefly review the operation.
- You will be taken to the operating room where you will be given medication to sleep.
- During sleep, the surgeon will inflate your abdomen with air to better visualize your internal organs and tissues.
- A small incision will be made in the belly button area through which a long, thin surgical instrument with an attached camera (called a laparoscope) will be inserted.
- Then additional small incisions will be made in the abdomen through which other surgical instruments will be inserted.
- With a camera and an image projected onto a television screen, the surgeon uses surgical instruments to put the bulging tissue back into place.
- Then the weakness in the abdominal wall will be sutured or stitched up with mesh.
- The abdomen will be deflated and the small incisions will be closed with stitches or surgical tape.
After the operation, you will be transferred to the recovery room for a few hours. Once the anesthesia is over and all symptoms, such as pain, are under control, you can go home.
Recovery from hernia repair surgery is typically one to two weeks for laparoscopic surgery and three weeks for open repair surgery .
To optimize healing and prevent complications, it is important to strictly follow the surgeon's postoperative instructions. These instructions may include the following :
- To reduce swelling, apply an ice pack or cold pack (not directly to your skin) every two hours for 15 minutes.
- To control pain, take Tylenol (acetaminophen) or, more importantly, the prescription opioid as directed.
- To prevent blood clots after surgery, be sure to get up and walk five to six times a day.
- To prevent infection, wash your hands before and after touching the incision (s).
- Avoid exercise for four weeks for laparoscopic surgery and six weeks for open surgery.
When to seek medical help
During your recovery, be sure to contact your doctor if you notice any of the following symptoms:
- Persistent, severe, or worsening pain
- Signs of infection at the surgery site: warmth, redness, increased swelling, and / or abnormal drainage.
- Persistent vomiting
- Do not defecate for two to three days after surgery.
Long term care
Since hernias do not heal or resolve on their own, the main advantage of surgery is that it offers definitive treatment (in most cases). This means that after you recover from your surgery, hopefully you will be able to return to your normal routine and daily life without visible pain, discomfort, or bumps.
In the long run, your surgeon will want you to stay healthy and aware of any lingering symptoms, especially pain. Unfortunately, a small group of patients develop chronic pain after hernia repair, usually associated with a nerve.
Finally, although it is rare for a hernia to reappear after surgery, it is possible. To prevent a relapse, your surgeon may recommend losing weight if you are obese .
The main risks associated with hernia repair include :
- Bleeding or bruising (when blood pools under the surgical site)
- Seroma (accumulation of fluid under the operative field)
- Infection, possibly of the surgical site or of the surgical mesh used for repair.
- Chronic postoperative pain
- Bowel or urinary problems (such as constipation or difficulty urinating)
- Injury or damage to a nerve or tissue (such as the intestines)
- Hernia recurrence
Get the word of drug information
Hernia surgery has come a long way. Surgeons can now choose between two different types of techniques, and the open procedure also allows for multiple anesthesia options.
If you are recommended for hernia repair, your surgeon will be your primary source of information relevant to your case to help you understand which method is best for you.