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.
An enlarged pancreas can occur for many reasons. The pancreas is a gland that sits behind your stomach in the upper abdomen and helps with digestion. It produces enzymes that are secreted into the small intestine, digesting protein, fat, and carbohydrates. The pancreas also produces insulin to help regulate blood sugar (glucose), the body's main source of energy.
Mesh patches of synthetic material are now being widely used to repair hernias (hernioplasty). This is
especially true for large hernias and for hernias that reoccur. Patches are sewn
over the weakened area in the abdominal (belly) wall after the hernia is pushed back
into place. The patch decreases the tension on the weakened belly 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
Don't do anything that causes pain. You'll probably be able to drive again in about 2 weeks or when you have no pain in your groin. You can have sexual intercourse in about 3 weeks.
Swelling over the incision is common after hernia surgery. It doesn't mean that the surgery was unsuccessful. Placing an ice pack on the incision
during the first 24 hours helps reduce swelling. Call your doctor if you have any of these symptoms:
The incision is noticeably warm and
A testicle is hard and swollen.
Your wound is bleeding through your bandage.
You have a fever.
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),
which results in an inability to father children.
Damage to the
femoral artery or vein.
What To Think About
The following people need special
preparation before surgery to reduce the risk of complications:
Those with a history of blood clots in large
blood vessels (deep vein thrombosis)
taking large doses of aspirin
Those taking anticoagulation
medicines (such as warfarin or heparin)
Most inguinal hernia repair surgery on adults of all ages
and healthy children is done on an outpatient basis. Outpatient surgery takes about 1 hour.
Open surgery is different from laparoscopic surgery for hernia repair in the
An open surgery requires one larger incision instead of several small
If hernias are on both
sides, a second incision will be needed to fix the other hernia. Laparoscopic surgery allows the surgeon to repair both hernias without making more incisions.
Open hernia repair can be done under general, spinal,
or local anesthesia. Laparoscopic repair requires general anesthesia.
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.
Primary Medical Reviewer
E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer
Kenneth Bark, MD - Surgery, Colon and Rectal
November 15, 2012
WebMD Medical Reference from Healthwise
November 15, 2012
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