Hernia Repair

Hernia repair is one of the most common types of surgery in the U.S.

The different types of hernias require different types of approaches, but the goal is always the same: to return the protruding organ or tissue back into place, and take steps to keep it there.

The size and location of the hernia are factors in determining approach. A very large and complicated hernia may require open surgery, while surgeons may be able to do smaller ones with laparoscopy.

Laparoscopic Hernia Repair

Laparoscopy is a minimally invasive procedure that avoids the body trauma of a large incision. During a laparoscopic hernia repair:

  • The surgeon makes three tiny incisions in the patient’s abdomen
  • The abdomen is inflated with carbon dioxide to give the surgeon room to work
  • Surgical instruments, a fiber optic light source and a tiny camera are inserted though the incisions
  • The surgeon puts the protruding organ or tissue mass back into place and uses a synthetic mesh to repair the abdominal weakness

After a laparoscopic surgical repair, most patients go home the same day and return to normal activities within a week.

Because hernias frequently occur on both sides of the abdomen, laparoscopic surgery avoids the need for the two long incisions necessary in an open procedure.

If you have a very large hernia, or your intestine is pushed down into the scrotum, or you’ve had previous pelvic surgery, you may not be a candidate for a laparoscopic procedure.

Open Hernia Repair Surgery

Many surgeons prefer to do open surgery for hernia repair as it may be the best choice for the patient, especially if they have a large complex hernia.

During traditional open surgery for hernia repair:

  • The surgeon makes one incision (typically from 2 to 4 inches) in the abdominal wall
  • The protruding tissue or organ is moved back into place
  • The surgeon closes the abdominal wall and reinforces it with synthetic mesh
  • The surgeon then closes the incision with several stitches

After an open hernia repair, patients typically go home the same day, but need to be on bed rest for at least a few days. Depending on the type of job you do, you may be away from work two weeks or more.

Abdominal Wall Hernias

Abdominal wall hernias include hernias of the groin, hernias of the upper and lower abdomen and hernias that result from prior abdominal and pelvic surgeries. Treatment options for abdominal wall hernia repairs have changed significantly in recent years. Hernia surgeons at Swedish perform minimally invasive surgery whenever possible. Techniques used include robotic surgery (where the surgeon controls the robot, making very small incisions) and laparoscopic surgery, described above. Both techniques often result in shorter hospital stays, less usage of pain medication, and a quicker return to work. 

Common types of abdominal wall hernias
  • Inguinal hernia
  • Fermoral hernia
  • Umbilical hernia
  • Incisional hernia
  • Epigastric hernia
  • Spigelian hernia
  • Diaphragmatic hernia

Swedish hernia surgeons specialize in large and complex hernias and participate in quarterly literature reviews, a national quality collaborative, and national hernia conferences. We believe that to provide the best care for our patients, we need to be the best that we can be. 

Choosing a Surgeon

Even though hernia repair is a common surgery, the potential for complications exists in any surgery. Numerous studies show that the outcome of a surgery depends in large part on the skill and experience of the surgical team.

That’s why it is important to choose your surgeon carefully. When talking with a surgeon, it is helpful to ask:

  • How many hernia repairs have you performed?
  • What were the outcomes of the surgeries?
  • What kind of experience does the surgical team have?
  • How many of these procedures are performed at the medical center each year?

You can also ask your surgeon to recommend another surgeon who can give you a second opinion about your procedure. Many people hesitate to seek a second opinion for fear of insulting their doctor. But, in fact, seeking a second opinion is a common medical practice.