Hernia Repair Surgery

What is hernia surgery (hernia repair surgery)?

Surgery is the most common treatment for a hernia. With a hernia, an organ pushes through the muscle or tissue wall that holds it. Most hernias form in your abdomen or groin. Hernia surgery allows your surgeon to push the organ and herniated tissue back into place and reinforce the barrier holding it there using stitches or surgical mesh.

Another name for hernia surgery is herniorrhaphy.

Who needs hernia repair?

Not all hernias require immediate treatment, but most eventually do since they usually worsen over time. Hernias can create bulges where interior tissue presses outward through a tear or gap in a muscle or tissue wall. They can also cause unpleasant symptoms, like pressure, discomfort or pain. Depending on where your hernia’s located, it can impact other organs and cause complications.

For example, if you have testicles, a hernia can slip past a muscle wall and into your scrotum, causing swelling, pain during sex or other issues.

If a hernia causes symptoms or puts you at risk of a complication, you may need surgery.

What are the types of hernia surgery?

The main types of surgery for hernia are:

• Open (traditional) hernia repair surgery: A surgeon makes a single incision (cut) that allows them to operate on the herniated tissue. They put the organs and tissue back into place and use surgical instruments to stitch the tissue back together to make it stronger. Surgeons often use surgical mesh to reinforce the tissue.
• Laparoscopic hernia repair surgery: During laparoscopy, or “keyhole surgery,” your surgeon uses several tiny cuts (usually three or four) to operate. Your surgeon inserts a thin tube with a tiny video camera (laparoscope) that projects images of your insides onto a screen. They insert surgical instruments into the other incisions that allow them to repair the hernia.
• Robotic hernia repair surgery: This type of laparoscopic surgery uses robotic surgical instruments to operate. Your surgeon works at a console driving the technology used to repair the weakened tissue causing your hernia.

How common is hernia repair surgery?

According to the FDA, surgeons perform more than 1 million hernia surgeries in the United States annually. Each year, about 20 million hernia surgeries are performed worldwide. Most treat inguinal hernias, the most common type.

How should I prepare for this procedure?

Your healthcare provider will determine whether you’re a candidate for hernia surgery. If you are, they’ll determine which type of surgery is best.

Preparation involves:

• Reviewing your medical history, including whether you’re pregnant.
• Reviewing your medications, including herbs and supplements you’re taking.
• Ordering blood tests or imaging to ensure you’re healthy enough for surgery.
• Providing instructions to prepare. For example, you may be asked to stop taking blood thinners, like aspirin. You also may need to fast before surgery.

You’ll need to arrange to have someone drive you home after surgery, as well.

What happens during hernia repair surgery?

The specific process depends on the surgery you need – open, laparoscopic or robotic. Generally, it goes like this:

1. You’ll receive medicines that prevent pain. You’ll likely need general anesthesia that puts you to sleep for laparoscopic surgery. For open surgeries, you may only need local or regional anesthesia. You’ll be awake for surgery but won’t feel any sensation in the area where your surgeon is operating.
2. The surgeon makes a single cut (several inches long) for open surgery or several small cuts (usually three or four, no longer than an inch or so) for laparoscopic surgery.
3. They’ll position the herniated tissue back into place and repair the weakened surrounding tissue. They may suture healthy tissue together to create a strong barrier wall. They also often use surgical mesh, which provides extra support to prevent a hernia from returning (recurring).
4. The surgeon will suture the incisions back together and dress your wounds.

How long does hernia surgery take?

Hernia surgery may take as little as 30 minutes for simple repairs and up to five hours for more complex repairs. It depends on your hernia and the type of surgery you need. Generally, robotic surgery repair takes longer than open or laparoscopic hernia surgery.

How painful is hernia repair surgery?

You won’t feel any pain under general anesthesia because you’ll be asleep. If you’re awake and getting local anesthesia, your provider may ask if you feel any discomfort. Let them know how you’re feeling so they can ensure the surgery’s pain-free.

Your healthcare provider will work with you to manage pain as you recover. For example, you may need pain relievers to manage pain for several days up to a few weeks following surgery.

What happens after this procedure?

Most hernia repair surgeries are outpatient, meaning you get to go home the same day of your surgery. You may need to stay in the hospital overnight for a night or two for more complex hernia repairs.

You’ll wake up in a recovery room, where your care team will monitor your vitals. It usually takes a few hours to regain your senses after the anesthesia.

Have someone drive you home, and plan to rest for the first 24 hours afterward. You should be able to do basic activities, like walking, but you should take it easy that first day.

What are the benefits of hernia surgery?

Hernia surgery is considered a safe procedure that can repair your hernia and prevent it from recurring. According to a recent study, only about 16% of people need additional surgery because their hernia returned within 10 years after the first surgery.

But recurrence rates vary depending on the type of surgery and where your hernia is located. There may be a slightly higher risk of a hernia returning with laparoscopic surgery. Still, laparoscopic and robotic surgery cause less scarring and usually involve fewer pain medicines, and they have a quicker recovery than open surgery.

Your healthcare provider will explain the benefits, including likely surgery outcomes, based on your hernia and overall health.

What are the risks or complications?

As with all surgeries, hernia surgery has some risks. Some you’re more likely to experience shortly after surgery. Others typically show up in the long term. Your care team will work to minimize and prevent these as much as possible.

Short-term complications or side effects following hernia surgery include:

• Infection at the incision site.
• Seromas (collection of fluid).
• Hematomas (collection of blood).
• Injury to nearby tissue, organs or blood vessels.
• Problems emptying your bladder (you may need a catheter in the short term to help).

Complications that occur after recovery often require a return visit to your provider to address. These include:

• Erosion or breakdown of the surgical mesh.
• Infection deep inside the tissue where the surgical mesh is.
• Hernia recurrence (although this is rare).

Pain during sex. In men and people assigned male at birth (AMAB), hernia repair in the groin area can damage the nerve vessels or disrupt blood flow, causing pain in your testicles or infertility. Still, the rate of testicular complications is low (.3% to 7.2%).

Some people experience long-term pain after surgery. Pain that lasts longer than three months is called post-herniorrhaphy neuralgia. If you’re diagnosed with this condition, you may need medications or surgery.

How long is recovery from hernia surgery?

Your recovery time depends on many factors, including your hernia type and how complex the surgery was.

Most people can return to work that isn’t physically demanding (like desk jobs) within a few days. You may need to wait a few weeks if you have a more physically demanding job that involves lifting things.

You should be able to engage in light exercise, like walking, the day after your procedure. But don’t exhaust yourself. You’ll gradually increase your activity level as you heal.

Ask your healthcare provider about your timeline based on your work and overall health.

When should I call my healthcare provider?

Call your healthcare provider if you notice any signs of a complication following surgery. Call if you notice:

• Fever and chills.
• Inability to poop (constipation) or pass gas.
• Pus draining from the incision.
• Pain, redness, warmth or swelling at the incision site.
• Blood seeping through your bandage.

Go to the ER if you notice signs of a blood clot in your leg (deep vein thrombosis, or DVT). Signs include:

• Pain in your leg (including your calf, behind your knee and thigh) or groin.
• Sudden swelling, warmth or redness in your leg or groin.

You should also go to the ER immediately if you notice signs of sepsis, a life-threatening medical emergency. Signs and symptoms include:

• Fever.
• Chills.
• A fast heart rate.
• High blood pressure.
• Warm or clammy/sweaty skin.
• Shortness of breath.

A note from Cleveland Clinic

It can be stressful imagining the repositioning and repairing involved with hernia surgery. But surgeons have been performing surgeries to correct hernias for centuries. Newer materials (like surgical mesh) and methods (like laparoscopic hernia repair) have only improved surgery outcomes, including recurrence rates and recovery time. Getting surgery can fix your hernia with little risk of it returning. Ask your surgeon what to expect based on your type of hernia and the type of hernia repair surgery they recommend.