Overview
What Is A Hernia Repair ?
A hernia results from the weakening of the abdominal wall. This weakening allows the contents of the abdomen to protrude from the normal boundaries. Hernias are repaired by implanting a sterile surgical mesh to strengthen the weakened abdominal wall.
What Happens On The Day Of Surgery ?
You will report to a pre-operative nursing unit, where you will change into a hospital gown. A nurse will review your chart and confirm that all paperwork is in order. You will be taken to a pre-operative holding area, and an anesthesiologist will start an IV. Before any medications are administered, your surgeon will verify your name and the type of procedure you are having. You will then be taken to the operating room. After the appropriate form of anesthesia is administered, surgery will be performed.
What Type Of Anesthesia Will Be Used ?
You will have a pre-operative interview with an anesthesiologist who will ask you questions regarding your medical history. Hernia repairs are performed under general anesthesia. With a general anesthetic, you will be unconscious during your surgery.
What Happens During Surgery, And How Is The Surgery Performed ?
If your surgery is performed laparoscopically, your surgeon will make three to four small incisions. Your surgeon will insert tube-like instruments through these incisions. The abdomen will be filled with gas to aid the surgeon in viewing the abdominal cavity. A camera, inserted through one of the tubes, will display images on a monitor located in the operating room. Other instruments will be placed through the additional tubes. In this manner, your surgeon will be able to work inside your abdomen without using a larger incision.
If the procedure cannot be performed laparoscopically, your surgeon will perform an open hernia repair. In an open hernia repair, your surgeon will make one larger incision to open the abdominal cavity and repair the hernia from this incision.
Once inside, your surgeon will suture a surgical mesh to strengthen the weakened muscle. The surgical mesh is made of a strong, sterile, synthetic material. When repairing a large abdominal hernia, your surgeon may insert a drain in the abdomen that will help to prevent postoperative fluid collection in the abdomen.
Once the surgery is completed, you will be taken to a post-operative or recovery unit where a nurse will monitor your recovery. It is important that your bandages be kept clean and dry. If a drain is in place, you will be given instructions on how to care for it when you are discharged. You may experience mild pain at the incision site so your surgeon will prescribe pain medication for you. You will be scheduled for a follow-up appointment within two weeks after your surgery.
What Are The Risks Associated With A Hernia Repair ?
As with any surgery, there are risks such as bleeding, infection, or an adverse reaction to anesthesia. Other risks include injury to the bowel or a recurrence of the hernia. Your surgeon will inform you of the risks prior to surgery.
What Should I Watch Out For ?
Be sure to call your doctor if any of the following symptoms appear:
- Fever or chills
- Persistent nausea or vomiting
- Drainage from any incision
- Inability to urinate
- Prolonged soreness
What Are Treatment Options ?
Traditional Approach
You may be given general, spinal or local anesthesia with sedation. An incision is made in the skin, fat layer, and level where the defect is located. Your surgeon may choose to use a piece of surgical mesh to repair the hole or weakened area.
Laparoscopic Hernia Repair
Your physician may recommend laparoscopic hernia repair surgery. With recent advances, the technique has been modified using a laparoscopic (advanced minimally invasive) approach that avoids the need for a large incision. There can be decreased pain in some patients. In laparoscopic inguinal hernia surgery, the patient is given general anesthesia or occasionally spinal or regional anesthesia. As many as three to four small incisions are made. One is used for the laparoscope which is attached to a camera that sends images to a video monitor.
The other incisions are used to hold or manipulate tissue in the abdomen. Carbon dioxide gas is inflated into the abdominal cavity to allow room to work and allow the surgeon to see. The defect is identified and carefully dissected and repaired. Your surgeon may perform a transabdominal (opens the peritoneum) laparoscopic repair or extraperitoneal laparoscopic repair (does not open peritoneum). Usually, a mesh is placed to cover and reinforce the weak area in the abdominal wall. The mesh acts as a patch. Mesh is secured by staples, clips or sutures and will remain permanently. Mesh or staple are not harmful to your body. At the end of the surgery, carbon dioxide gas is removed.
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