Inguinal Hernia Repair


What is a hernia?

A hernia (or rupture) is an area of weakening in the muscles of the belly. Often, there is a visible bulge which consists of something within the abdomen pushing through the weakness in the muscles.

If this hernia is in the groin, we call it an inguinal hernia. Many people are born with the potential for the muscle weakness, but the hernia does not enlarge and appear until much later in life. Some of the reasons why a hernia might appear are: heavy lifting, excessive coughing, constipation or straining with urination. Once a hernia appears it will not go away and may get bigger.

Often, the hernia contains some intestine which slides down into the hernia when you stand up. This may slip back inside the belly when you lie down. The danger to leaving a hernia untreated is that it is possible for the intestine to get stuck in the hernia, and this could block the intestine. If it is stuck too tightly the blood supply to the intestine can get cut off and gangrene can occur. This would be a life threatening problem which would require emergency surgery to correct. That is why we recommend repair of your hernia before this happens.

The only other way to treat a hernia is with a truss. I do not recommend this because it is uncomfortable, it may not keep the hernia in place properly, and it will make later surgery more difficult.

Preparation for the operation
Unless a patient has other health problems this operation is usually done as an outpatient. This means that a patient comes to the surgery center or hospital in the morning and has the operation shortly thereafter. After time for recovery the patient can go home later in the day if all goes well.

A hernia can be repaired using local anesthesia (Novocain), spinal anesthesia, or general anesthesia (asleep). Whichever type of anesthetic is used, the additional injection of a long acting local anesthetic is used to decrease or eliminate the pain for the first 8-12 hours after the operation.

What is the operation like?
The operation for repair of a hernia begins with an incision over the lower portion of the belly, because that is where the muscles have weakened. The bulge is then opened, or pushed back in, and the muscle weakness closed with stitches or repaired with mesh. The incision is then closed. Inguinal hernias can also be repaired laparoscopically, but we recommend the open type of repair for the best results.

After the operation
Most people recover from hernia surgery very quickly and are up walking the day of the operation. We usually recommend that a patient prepare to take about a week off of work. After that, return to work depends on the type of activities that need to be done at work. It is best to avoid any heavy lifting for about four to six weeks after the procedure.