Hernia Surgery

What is Herniorrhaphy?

Herniorrhaphy is surgery to correct a hernia and is carried out using a variety of techniques depending on the location and size of the protrusion.
A hernia is a general term referring to a protrusion of tissue through the wall of the cavity in which it is normally contained. Most areas of the body are separated by tissue walls that are made up of muscle, fascia (a thick band of fibrous tissue), or other structures. Occasionally, a weakness will develop in a tissue wall allowing the contents to push outward or sometimes to push completely through the wall. These weak points tend to develop in similar areas for most people and therefore are usually well understood and easily recognized by a physician.

Who are candidates for Hernia Repair?

If the hernia causes significant pain or allows a lot of tissue to protrude through a structural wall, your physician may recommend hernia repair. Some hernias do not cause significant problems and are not treated with surgery.

Two types of hernias are especially common:

Inguinal Hernias: occur along the front of the pelvis near the abdomen. Inguinal hernias are more common in men and may include symptoms such as pain or a lump in the side of the scrotum.
Umbilical Hernias: develop near the umbilicus, which is the medical term for “belly button.” They occur because there is a natural thinning of the abdominal wall at the location where our umbilical cord exited our bodies in the womb. Pregnancy or obesity can cause an umbilical hernia or make a small hernia larger.

These are the most common types, but hernias can occur almost anywhere in the body.

What is the Hernia Repair recovery process?

You will likely go home on the same day of the surgery or the day after surgery. Complete recovery from surgery varies depending on your circumstances. You may recover in two to four weeks or up to six months.
You should be careful when you bathe as not to get the incision site wet. You should avoid heavy lifting and strenuous activity for six to eight weeks.

What are alternatives to Hernia Repair?

Most hernias do not require surgery and are often simply monitored by your physician. Persistently painful hernias, or those that become enlarged or potentially trap or pinch other structures (like intestines) must be treated surgically.

What is a hernia?

You have a swelling or pain in the tummy button, called your umbilicus. This is due to a rupture, known as a hernia. Because of its position in the tummy button, the rupture is called an umbilical hernia.

A hernia is a pouch that pushes through a muscle sheet, such as the tummy wall. Before birth, there is always a gap and a hernia in the tummy button, where the umbilical cord is attached to the unborn child. This usually disappears before birth, but there is often a weakness there throughout life.

What has gone wrong?

The hernia pouch or sac is the lining of the inside of the tummy wall. It pushes through the weakness at the tummy button. The sac has a fatty covering and inside there may be bowel or fatty tissue called omentum. The sac steadily gets larger and can be painful. The bowel and omentum may get stuck in the sac. Their blood supply can be cut off and the bowel and omentum can strangulate and die. This causes vomiting, great pain and is very serious. Sometimes a hernia appears as the nearby body wall weakens with the passing of time.
Sometimes the hernia is caused when coughing, heavy work or sport overstrains the tissues.
Umbilical hernias are very common and easily treated, particularly when small. If treated when they are small, this will prevent strangulation and make the strongest repair.

The aims of surgery:
The aims are threefold.

To remove any bowel or omentum from the hernia. This usually means pushing them back inside the tummy cavity. If the bowel or omentum is strangulated, they may need to be removed.
To remove or push back the sac.
To repair the weakness to prevent the hernia coming back.

The most common way to do the operation is while you are asleep with a general anaesthetic. A local anaesthetic may be used for a very small hernia.

The benefits:

You should stop having pain and the swelling will be gone. There should be no risk of strangulation.
Are there any alternatives?

Simply waiting and seeing if you have more trouble, is reasonable if the hernia is not giving any pain.

The repair of a very large hernia can be a major operation. A balance is needed between the risks of the operation and the risks of the hernia strangulating. An abdominal support may be worthwhile if an operation may be dangerous.

Some very large hernias have several loops of bowel in them. If one loop strangulates, it may be safer to limit the operation to the removal of the damaged bowel and to not add the risks of a hernia repair at that time.