Open Inguinal Hernia Repair (Herniorrhaphy, Hernioplasty)
For open hernia repair surgery, a single
long incision is made in the groin. If the hernia is bulging out of the
abdominal wall (a direct hernia), the bulge is pushed back into place. If the
hernia is going down the
inguinal canal (indirect), the hernia sac is either
pushed back or tied off and removed.
The weak spot in the muscle
wall-where the hernia bulges through-traditionally has been repaired by sewing
the edges of healthy muscle tissue together (herniorrhaphy). This is
appropriate for smaller hernias that have been present since birth (indirect
hernias) and for healthy tissues, where it is possible to use stitches without
adding stress on the tissue. But the surgical approach varies depending on the
area of muscle wall to be repaired and the surgeon's preference.
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Mesh patches of synthetic material are now being widely used to repair hernias (hernioplasty). This is
especially true for hernias that recur and for large hernias. Patches are sewn
over the weakened area in the abdominal wall after the hernia is pushed back
into place. The patch decreases the tension on the weakened abdominal wall,
reducing the risk that a hernia will recur.
What To Expect After Surgery
Most people who have open
hernia repair surgery are able to go home the same day. Recovery time is about
most likely can return to light activity after 3 weeks. Strenuous exercise should wait until after 6 weeks of
Why It Is Done
Surgical repair is recommended for
inguinal hernias that are causing pain or other
symptoms and for hernias that are
strangulated. Surgery is always recommended for
inguinal hernias in children. Infants and children usually have open surgery to
repair an inguinal hernia.
Open surgery for inguinal hernia
repair is safe. The recurrence rate (hernias that require two or more repairs)
is low when open hernia repair is done by experienced surgeons using mesh
patches. Synthetic patches are now widely used for hernia repair in both open
and laparoscopic surgery.
The chance of a hernia coming back after
open surgery ranges from 1 to 10 out of every 100 open surgeries done.1
Adults and children who have a hernia repair are at risk
Reaction to anesthesia (main
Infection and bleeding at the site.
damage, numbness of skin, loss of blood supply to scrotum or testicles
resulting in testicular atrophy (all infrequent).
Damage to the
cord that carries sperm from the testicles to the penis (vas deferens),
resulting in an inability to father children.
Harmon JW, Wolfgang CL (2007). Hernias of the groin
and abdominal wall. In NH Fiebach et al., eds., Principles of Ambulatory Medicine, 7th ed., pp. 1673-1681. Philadelphia: Lippincott
Williams and Wilkins.
Other Works Consulted
Society for Surgery of the Alimentary Tract (2006). SSAT patient care guidelines: Surgical repair of groin hernias. Available online: http://www.ssat.com/cgi-bin/hernia6.cgi.
Primary Medical Reviewer
Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer
C. Dale Mercer, MD, FRCSC, FACS - General Surgery
April 26, 2011
WebMD Medical Reference from Healthwise
April 26, 2011
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