Hernia Repair

An open hernia repair is a complex procedure that requires general anesthesia or local anaesthetic with sedation.

Symptoms

• Pain in the area of the hernia, typically with movement, coughing, activity, straining, etc.
• A bulge with standing/activity/straining that improves with laying flat.
• Rarely, intestine can become stuck through the hole (hernia) and the blood supply can be cut off (called strangulation). This will cause severe pain and vomiting, with a painful bulge at the site of your hernia. This is an emergency and you need to go to the ER to be evaluated immediately.

Treatment Options

• Hernia repair
  • Laparoscopic or open
• Watchful waiting
  • If asymptomatic (no symptoms) or high risk of surgery, watchful waiting may be appropriate.

• Umbilical or Ventral
  • Open
    • Incision over the hernia bulge
    • Replace intra-abdominal organs/tissue
    • Close the hernia (hole in the muscle) with sutures, with or without mesh

• Laparoscopic
  • 3-5 small incisions with hollow tubes placed to use instruments and a lighted camera
  • Carbon dioxide is used to make space between your organs to work with small instruments
  • Intra-abdominal tissue/organs pulled back into the abdomen
  • Hernia (hole in muscle) is closed with sutures, likely with mesh placement beneath this to strengthen the repair

• Complex abdominal wall hernias
  • If you have a high risk hernia, you may need a more specialized operation to address your hernia
  • This may require advanced techniques to re-structure the muscles in your abdominal wall to give you the best chance at a successful repair
  • You may be required to stop smoking, lose weight and/or control diabetes or chronic medical issues as these repairs are high risk
  • Your repair will be tailored to your specific situation by your surgeon

• After surgery you will not have the symptoms you were having from your hernia
• Most people never have a recurrence of their hernia once fixed, but this can happen at any time in your future
• If you develop continued pain >3 months from your surgery, please call to discuss further evaluation and treatment options.

What to expect

Day of Surgery

• You will receive general anesthesia for your surgery. The anesthesia provider will meet with you the morning of surgery to discuss this and address any concerns
• Most people go home within a few hours after surgery
• You will need someone to drive you home and be close for the first night following your surgery

Postoperatively

• Eat a normal diet, start with bland foods. Ensure you are drinking 8-10 glasses of water a day after surgery. Eat high-fiber foods or take fiber supplement (ex. Metamucil) to help with your bowel movements after surgery.
• If you had a laparoscopic repair it is normal to have pain, especially in your shoulder/neck area, and with deep breathing. This is from the gas used during surgery and will resolve within a couple days. Changing positions can help.
• You will be sent home with pain medication which most people will take for a few days after surgery then are able to wean to non-narcotic mediations
• Take ibuprofen (unless you have a medical reason not to) in addition to help decrease the amount of narcotic you are taking.
• Norco (the narcotic most commonly prescribed) has Tylenol in it. Either take norco OR Tylenol in addition to the ibuprofen.
• Take stool softeners and/or laxatives as needed (docusate, miralax) to help your bowels stay regular following surgery. Anesthesia and pain medications can contribute to constipation postoperatively.
• Walk around as able. Take deep breaths to fully expand your lungs. This can help prevent pneumonia and blood clots
• Most people will be able to return to work or school about 5-7 days after surgery.
• Increase your activity as able. You will likely be given a lifting restriction after your surgery. Your surgeon will discuss this with you based on your repair.
• Wound care.
  • All sutures used will be buried under the skin and absorbable.
  • If you have steri strips over your incisions. Remove bandaids in 24-48hrs after surgery. Leave white strips (steri strips) in place and shower. Let soapy water run over these and pat dry. They will begin to peel off in about 7-10 days then you may remove.
  • If you have skin glue (dermabond) over the incisions you may shower immediately. When this begins to flake off you may peel off, typically in a week.
  • Do not bathe, soak incisions, go in hot tube, pool or lake/ocean for 2 weeks.
  • Your scar with heal over the next 4-6 weeks and continue to fade and soften over the next year. Use sunscreen over incisions when exposed to sun for the next year.
  • It is normal to have a fluid collection form in the area of your hernia after it is repair. Initially this feels soft, but then hardens over the next few days. This does not mean your hernia has returned. Your body will continue to reabsorb this fluid over the next weeks and it will eventually soften and flatten out.

Patient Information & Documents