What Is Hernia Surgery? An In-Depth Guide

Introduction to Hernia and Hernia Surgery

A hernia occurs when there is a defect or “hole” in the fascia, the protective layer in your abdominal wall. This allows underlying fat or internal organs to protrude, creating a noticeable bulge. Hernias commonly appear in the groin, belly button, or at previous surgical sites. There are several types of hernias. Some of the most common are inguinal hernias, femoral hernias, umbilical hernias, and incisional hernias.  

Hernias develop due to weakness in the abdominal wall and increased pressure. Symptoms often include a visible bulge, pain or discomfort (especially when coughing, bending, or lifting), and a feeling of heaviness in the affected area.

While concerning, not all hernias require surgery. Surgery is recommended when symptoms interfere with daily life, the hernia is growing, or there is a risk of complications such as strangulation, where blood supply to the herniated tissue is cut off. It is important to seek medical attention so a qualified doctor can help you determine the best hernia treatment.

Types of Hernia Surgeries

Hernia repair has evolved significantly, offering patients a range of surgical options. Today’s hernia specialists wield an array of techniques, each tailored to address specific types of hernias and patient needs. From traditional open surgery to laparoscopic techniques to cutting-edge robotic assistance, these methods vary in approach, recovery time, and suitability. 

Hernia repair primarily uses two methods: open surgery and laparoscopic surgery. Open surgery requires a single, larger incision (typically two to four inches) for direct access to the hernia site. Laparoscopic surgery employs several small incisions (usually 0.5 to 1 inch each) and uses a camera and specialized tools for a minimally invasive approach. Both techniques aim to return protruding tissue to its proper place and reinforce the weakened area, often using surgical mesh. The choice between methods depends on factors such as hernia size, location, and the patient’s overall health.

Open surgery offers direct visualization, making it ideal for larger or more complex hernias. It may require a longer recovery period but allows for extensive reconstruction when needed. Laparoscopic surgery, with its smaller incisions, typically results in less postoperative pain and quicker return to normal activities. It is particularly effective for bilateral or recurrent hernias. Surgeons often prefer open surgery for large hernias or those requiring significant reconstruction, while opting for laparoscopic techniques for smaller hernias or when minimal scarring is desired.

Emerging technologies are expanding the frontiers of hernia repair. Robotic-assisted surgery represents a significant advancement in minimally invasive techniques. This approach combines the benefits of laparoscopic surgery with enhanced precision and control. While not yet as widely available as traditional methods, robotic-assisted hernia repair is gaining traction in specialized centers and may offer advantages for certain patients.

Preparing for Hernia Surgery

Proper preparation is key to a successful hernia repair. Your general surgical care team will guide you through several important steps to ensure you are ready for the procedure.

Pre-surgical evaluations:

Before your surgery, expect to undergo a series of medical evaluations. These typically include:

• A comprehensive physical exam
• Blood tests to check your overall health and clotting ability
• Possible imaging studies like ultrasound or CT scan to precisely locate and assess the hernia
• Review of your medical history and any current medications

Preparing for your procedure:

Your surgeon will provide specific guidelines to prepare you for surgery. These typically include fasting for eight to 12 hours before the procedure and possibly adjusting your medication regimen, particularly for blood thinners. You may also be advised to make lifestyle changes, such as quitting smoking and limiting alcohol intake, to improve your recovery. It is crucial to arrange for post-surgery care and transportation home in advance. These preparations help ensure a smooth surgical experience and set the foundation for a successful recovery. Always follow your surgeon’s instructions closely, and do not hesitate to ask questions if anything is unclear.

On the day of surgery:

On surgery day, you will want to arrive prepared and punctual. Bring your ID, insurance information, and medical documents, but leave valuables at home. Opt for loose, comfy clothes – you will be changing into a hospital gown. The surgical team will review your medical history, prepare you for surgery, and start an IV. You will meet your anesthesiologist to discuss the anesthesia plan and address any questions or concerns you might have. Remember, your surgical team’s goal is to ensure you feel as comfortable and informed as possible about your procedure.

“A mammogram also requires you to stand, so be sure also to wear comfortable shoes, such as sneakers or flats, and leave any heels or wedge sandals in the car,” advises Dr. Tammaro.

The Hernia Surgery Procedure

While the exact steps may vary based on your specific condition and chosen surgical method, here is a general breakdown of what you can expect during hernia surgery and treatment:

1. Anesthesia administration: Depending on the type of hernia and surgical approach, you will receive either local, regional, or general anesthesia to ensure your comfort during the procedure.
2. Incision: For open surgery, the surgeon makes a single incision near the hernia site. In laparoscopic surgery, several small incisions are made to insert the camera and surgical instruments.
3. Identifying the hernia sac: The surgeon locates the hernia sac, which contains the protruding tissue or organ.
4. Reducing the hernia: The contents of the hernia sac are gently pushed back into their proper position within the abdominal cavity.
5. Repairing the defect: The weakened area of the abdominal wall is reinforced. This often involves placing a surgical mesh to strengthen the area and prevent future herniation.
6. Closing the incision(s): The surgeon closes the incision(s) using sutures, staples, or surgical glue, depending on the type of surgery and location of the hernia.
7. Moving to recovery: After the procedure, you are moved to a recovery area where medical staff monitor your vital signs as you wake from anesthesia.

The entire process typically takes one to two hours, though this can vary based on the complexity of the hernia and chosen surgical technique. Surgeons tailor their hernia repair approach by considering multiple factors. They assess the patient’s health, the hernia’s characteristics, and whether it is recurrent. The surgeon’s expertise and patient preferences are also taken into account. This comprehensive evaluation allows them to choose the most suitable technique, balancing effectiveness, safety, and recovery time for each unique case.

Your anesthesiologist will determine the type of anesthesia used based on the type of hernia, location, and your medical history. They will also help coordinate your post-surgical pain management plan. This may involve various techniques like oral medications or nerve blocks. Effective pain control enhances comfort, promotes earlier mobilization, and speeds recovery. 

Recovery and Aftercare Following Hernia Surgery

While each patient’s healing journey is unique, knowing what to expect, following your doctor’s instructions, and staying alert for potential issues can pave the way for a smoother, more successful recovery process, enabling you to return to the activities you love.

General recovery timeline:

• First 24-48 hours: Rest and pain management
• 1-2 weeks: Gradual return to light activities
• 4-6 weeks: Resume normal routines
• 6-8 weeks: Full recovery for most patients

Key post-operative care:

• Follow your pain management plan
• Keep the incision site clean and dry
• Increase activity gradually as advised
• Avoid heavy lifting for 4-6 weeks
• Attend all follow-up appointments

Complications to watch for:

• Excessive pain or swelling
• Fever or chills
• Incision site redness or discharge
• Nausea or vomiting
• Difficulty urinating

Contact your healthcare provider immediately if you experience any concerning symptoms. Remember, the New Jersey hernia specialists at Premier Surgical Network is here to support you throughout your recovery journey.