Hernia Repair Surgery: When Is It Needed and What Are the Options?

Content medically reviewed by David Vavra, MD

One of the most common operations performed in the United States is hernia surgery. A hernia is when an organ in your body bulges through a weak spot or hole in the tissue containing it. If you are diagnosed with a hernia, treatment depends on the type of hernia and whether it is causing symptoms or not. Watchful waiting may be appropriate for some people with minimal symptoms, although it is still essential to be evaluated by a medical provider. In other cases, the best way to manage a hernia is with surgery.

“Hernias do not go away on their own and tend to get bigger with time,” said Dr. David Vavra, general surgeon at Essentia Health. “Surgery can resolve symptoms and prevent long-term complications.”

Types of Hernia Surgery

If you have a hernia that is enlarging, causing significant discomfort, or if you are at risk for complications like a bowel obstruction, surgery to repair the hernia should be strongly considered. Depending on various clinical factors and the type of hernia, surgery may be approached in several ways –

• Open surgery. In open surgery, the surgeon makes an incision near the hernia and places the hernia contents back into the abdomen. The surgeon then uses stitches to close the hole or weakness in the tissue. In many cases, surgical mesh is also used to reduce tension, strengthen the area where the hernia occurred, and help prevent hernias from returning. If the hernia is small, open surgery can often be done using local anesthesia with sedation. Larger hernias require general anesthesia.
• Laparoscopic surgery. Laparoscopic surgery is a minimally invasive approach that begins with a harmless gas being injected into your abdomen to inflate it, giving the surgeon space to work. The surgeon then makes a small incision and inserts a camera, which transmits images of your anatomy to a screen the surgeon uses for guidance during the procedure. Using long instruments through other small incisions, the surgeon reduces the hernia and its contents. Mesh is then secured over the weak spot. Your abdomen is deflated at the end of the procedure, and the small incisions are closed with sutures. This type of minimally invasive surgery is performed using general anesthesia.
• Robotic surgery. This type of procedure is similar to laparoscopic surgery, but the surgeon sits at a console controlling robotic arms. This allows for more precision as the robot mimics the surgeon’s hand movements using tiny tools inserted through small incisions. Minimally invasive surgery has numerous benefits, including reduced postoperative pain, less blood loss, smaller scars, lower risk of infection, faster recovery times, and shorter hospital stays.

The duration of hernia surgery depends on the type of surgery performed and the size and location of the hernia. The procedure can take anywhere from 30 minutes to several hours. Often, patients can go home the same day.

What are the different types of hernias?

The most common type of hernia is called an inguinal hernia. These occur in the groin region. Inguinal hernias mainly affect men, although they can occur in women as well.Other types of hernias include –

• Femoral hernia. This type of hernia can be found in the upper thigh region and is most common in women.
• Ventral hernia. Occurring in the abdominal wall, this type of hernia includes incisional hernias that develop at incisions of previous surgeries and epigastric hernias which present above the belly button. Umbilical hernias are also included in this category and occur near the belly button. They are most common in babies but can develop in adults as well.
• Hiatal hernia. This happens when a portion of the stomach protrudes into the chest. When this occurs, it can result in worsening reflux symptoms, difficulty breathing, or chest pain.Most hernias, with the exception of hiatal hernias, cause a noticeable bulge or lump. They are often painful, with discomfort increasing when standing up or lifting heavy objects.

Recovering from Hernia Repair Surgery

Most people can return to driving and light activities within a few days of surgery. You may need to wait two weeks or more to return to physically demanding jobs and strenuous activities. Minimally invasive surgery usually allows for a faster return to regular activities compared to an open hernia repair.

When discussing a hernia repair surgery, your surgeon will cover the expected recovery time after the operation and make personalized suggestions about when to return to activity.