Hernia Repair

What Is a Hernia?

A hernia (or “rupture”) is a weakness or defect in the wall of the abdomen. This weakness may be present at birth. Or, it can be caused by the wear and tear of daily living. If left untreated, a hernia can get worse with time and physical stress.

When a Bulge Forms

A weak area in the abdominal wall allows the contents of the abdomen to push outward. This often causes a noticeable bulge under the skin. The bulge may get bigger when you stand and go away when you lie down. You may also feel pressure or discomfort when lifting, coughing, urinating, or doing other activities.

Type of Hernias

The type of hernia you have depends on its

Surgery: The Best Treatment

A hernia will not heal on its own. Surgery is needed to repair the defect in the abdominal wall. If not treated, a hernia can get larger. It can also lead to serious medical complications. The good news is that hernia surgery can be done quickly and safely. In most cases, you can go home the same day as your surgery.

How a Hernia Develops

Although a hernia bulge may appear suddenly, hernias often take years to develop. They grow larger as pressure inside the body presses the intestines or other tissues out through a weak area. With time, these tissues can bulge out beneath the skin.

Stages of Hernia Development

The wall weakens or tears: The abdominal lining bulges out through a weak area and begins to form a hernia sac. The sac may contain fat, intestine, or other tissues. At this point, the hernia may or may not cause a visible bulge.
The intestine pushes into the sac: As the intestine pushes further into the sac, it forms a visible bulge. The bulge may flatten when you lie down or push against it. This is called a reducible hernia and does not cause any immediate danger.
The intestine may become trapped: The sac containing the intestine may become trapped by muscle (incarcerated). If this happens, you won’t be able to flatten the bulge. You may also have pain. Prompt treatment may be needed.
The intestine may become strangulated: If the intestine is tightly trapped, it becomes strangulated. The strangulated area loses blood supply and may die. This can cause severe pain and block the intestine. Emergency surgery is needed.

Having Hernia Surgery: Traditional Repair

Surgery treats a hernia by repairing the weakness in the abdominal wall. An incision is made so the surgeon has a direct view of the hernia. The repair is then done through this incision (open surgery). To repair the defect, a mesh patch may be sewn (sutured) in place, to make a “traditional repair.” Follow your doctor’s advice on how to get ready for the procedure. You can usually go home the same day as your surgery. In some cases, though, you may need to stay in the hospital overnight.

Hernia Program

The physicians of the VSA Hernia Center are Board Certified or Board Eligible General Surgeons with a combined experience of more than 100 years of hernia surgery. VSA surgeons have been recognized throughout the region as pioneers and leaders in the field, and are responsible for training many local surgeons and others throughout the nation in the art and science of hernia surgery.

PDF Download: Virginia Surgery Associates, P.C. Hernia Program

Getting Ready for Surgery

Your doctor will talk with you about preparing for surgery. Follow all the instructions you’re given and be sure to:

The Day of Surgery

Arrive at the hospital or surgical center at your scheduled time. You’ll be asked to change into a patient gown. You’ll then be given an IV to provide fluids and medication. Shortly before surgery, an anesthesiologist will talk with you. He or she will explain the types of anesthesia used to prevent pain during surgery. You will have one or more of the following:

Risks and Complications

During the Surgery

To make a traditional repair, an incision is made over the hernia. A piece of mesh is inserted to cover the area of the abdominal wall defect without sewing together the surrounding muscles. The mesh is safe and generally well-accepted by the body’s natural tissues.

After Surgery

When the procedure is over, you’ll be taken to the recovery area to rest. Your blood pressure and heart rate will be monitored. You’ll also have a bandage over the surgical site. To help reduce discomfort, you’ll be given pain medications. You may also be given breathing exercises to keep your lungs clear. Later, you’ll be asked to get up and walk. This helps prevent blood clots in the legs. You can go home when your doctor says you’re ready.

Having Laparoscopic Hernia RepairOnce you know you have a hernia, you and your doctor can discuss laparoscopic surgery to repair it. Laparoscopic surgery is done with a laparoscope, a tiny “telescope” attached to a camera. It allows your surgeon a close-up view of your hernia using only small incisions. Because large incisions are not required, recovery from laparoscopic surgery is often faster and less painful than after open surgery. The surgery usually takes 1 – 2 hours. You can likely go home the same day.

Preparing for Surgery

Just Before Surgery

During the Procedure

At VSA the totally extra peritoneal repair (TEP) approach during surgery is generally used. This provides for the placement of a large preperitoneal mesh with rapid return of patients to normal activity after repair and excellent long-term results.

Placing the Patch

The surgeon repairs the hernia, then places strong mesh directly over the weak spot in your abdominal wall. The mesh acts just as a patch would on a tire wall. The mesh is secured with surgical staples, tacks, clips, or sutures. These stay in place permanently. Neither the mesh nor the staples are harmful to your body. Other reinforcement methods besides mesh may be used. After the mesh is applied, the gas is released from your abdomen.

Risks and Possible Complications

Discharge Instructions for Hernia Surgery

Arrange to have an adult drive you home after surgery. If you had general anesthesia, it may take 24 hours or more to fully recover. During this time, don’t drive, use machinery or power tools, drink alcohol, or make any major decisions.

Discharge Instructions for Hernia Surgery

The following are common after hernia surgery:

CARE FOR THE INCISION:

Arrange to have an adult drive you home after surgery. If you had general anesthesia, it may take 24 hours or more to fully recover. During this time, don’t drive, use machinery or power tools, drink alcohol, or make any major decisions.

DIET:

For the first 24 hours after surgery, you may not have much of an appetite or feel able to tolerate heavy foods. We encourage you to keep up with your liquids. As your appetite increases, you will find yourself eating normally. There are no restrictions- just eat what your system can tolerate.

MEDICATION:

You will be given a prescription for pain medication. Take this as directed for post-operative pain. If you are experiencing only mild discomfort, you may find over-the-counter medications, such as Tylenol (acetaminophen) or Advil/Nuprin (Ibuprofen), may be all you need for comfort. If constipation becomes a problem, an over-the-counter stool softener (Metamucil) or a mild laxative (Milk of Magnesia) may be taken.

WHAT TO LOOK FOR:

You may notice a slight drainage (usually pink or reddish in color), bruising, or slight swelling around the incision. This is normal and not cause for concern. Likewise, it is normal to have a lump or hardness under or near the incision. You may also have bruising and some swelling of the genitalia, which is not uncommon. However, please call our office immediately if you develop any of the following: excessive drainage, redness or swelling at or around the incision, fever over 100.5°F, persistent nausea or vomiting, or difficulty with urination.

REDUCING SWELLING:

Early on, it’s common for the area around your incision to be swollen, bruised, and sore. To reduce swelling, put an ice pack or bag of frozen peas in a thin towel. Place the towel on the swollen area 3 – 5 times a day for 15 – 20 minutes at a time. Immediately post-operative, it is recommended men wear briefs in place of boxer shorts to provide additional support. This also aids in reducing post-operative swelling. If needed, an athletic supporter may be worn.
An ice pack helps reduce swelling.FOLLOW UP: You will be seen in our office 7 to 10 days after your surgery and again in several weeks. Prior to surgery, you should have made an appointment for your first post-operative visit. If for some reason that appointment was not scheduled, please call our office at (703) 359-8640 as soon as your return home to schedule your appointment.IF DIFFICULTIES ARISE: Please call us if any problems or questions arise. We can be reached any time, including evenings and weekends, by calling our office number (703) 359-8640.

When to Call Your Doctor

Call your doctor immediately if you have any of the following:

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*Disclaimer About Surgery
This information is not intended as a substitute for professional medical care. Always follow your health care provider’s instructions.