Hernia Repair

(Herniorrhaphy)

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Definition | Body Parts Involved | Reasons for Procedure | Complications | What to Expect | Outcome | Call Doctor If

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Definition

Surgical procedure to fix a hernia. A hernia is a weak spot or tear in the abdominal muscle that allows a part of the intestine to bulge through. Hernias most frequently occur in the groin (called inguinal), near the navel (called umbilical), or at the site of a prior surgery (called incisional).

Parts of the Body Involved

Intestines and abdomen or groin

Reasons for Procedure

Hernia repair is used to correct a weak spot in the muscles of the abdomen or groin. The procedure is most often performed for the following reasons:

• To fix the weak spot before the bowel or other abdominal tissue becomes caught in the opening, which can become a medical emergency
• To correct the defect before it enlarges

Risk Factors for Complications during the Procedure

• Pre-existing medical condition
• Obesity
• Prior abdominal surgery and scarring

What to Expect

Prior to Procedure

Your doctor will likely do the following:

• Physical exam
• X-rays to check for intestinal blockages
• Blood tests

In the days leading up to your procedure:

• Review your regular medications with the surgeon; aspirin, anti-inflammatory medications, and anti-coagulant (blood-thinning) drugs may need to be stopped for a period of time before the procedure. Follow the surgeon's instructions about discontinuing these drugs.
• Arrange for a ride to and from the procedure
• The night before, eat a light meal and do not eat or drink anything after midnight unless told otherwise by your doctor
• Shower the evening before or the morning of your procedure

During Procedure - IV fluids, anesthesia, possibly a sedative

Anesthesia - General, local, or spinal anesthetic, depending on the procedure

Description of the Procedure - There are two approaches to repairing a hernia: the open surgical method (traditional) and the laparoscopic approach. The type of procedure used depends on the number of hernias needing correction and whether previous repairs have been made.

Traditional or open procedure: The surgeon makes a cut in the skin over the hernia site. The bulging tissue is pushed back into the abdomen and the muscle brought together and held in place with stitches. Alternately, a piece of mesh may be sewn in place to cover the hole.

Laparoscopic procedure: The doctor inserts a laparoscope, a thin, flexible instrument that lights the area and allows the doctor to view the interior of the body on a screen. Other instruments are inserted through additional small cuts made in the skin. The surgeon, working inside the body cavity, staples or clips a piece of mesh to the tissue to close the opening made by the hernia.

After Procedure - You'll be monitored in the recovery room until you're fully awake

How Long Will It Take? Less than one hour

Will It Hurt? Anesthesia prevents pain during the procedure. You may have some soreness for a few days after the surgery, but pain medication should relieve this discomfort.

Possible Complications:

• Infection
• Excessive bleeding
• Damage to blood vessels, nerves, or organs
• Difficulty urinating or scrotal swelling (with inguinal hernia repairs)
• Scar tissue formation
• Recurrence of hernia
• Anesthesia-related problems

Average Hospital Stay - None

Postoperative Care:

• Get up and walk around the day after surgery
• Keep the incision area clean and dry
• Do not lift heavy objects
• Drink plenty of fluids and eat plenty of high-fiber foods (fruits, vegetables, beans, and whole grains) to prevent constipation and straining during bowel movements
• Move your bowels as soon as you feel the urge

Outcome

After an open procedure, recovery generally takes four to six weeks; recovery is quicker following a laparoscopic procedure.

When you can return to work will depend on the demands of your job. Most patients having a laparoscopic repair can return to their jobs within a couple of weeks.

Call Your Doctor If Any of the Following Occurs

• Signs of infection, including fever and chills
• Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
• Difficulty urinating
• Pain not relieved by medication
• Following surgical procedures with general anesthesia: cough, shortness of breath, chest pain, or severe nausea or vomiting

SOURCE:

Society of American Gastrointestinal Endoscopic Surgeons

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Last reviewed April 2001 by Medical Review Board