Open Inguinal Hernia Repair (Herniorrhaphy, Hernioplasty)

Surgery Overview

For open hernia repair surgery, a single long incision is made in the groin. 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.

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 belly wall after the hernia is pushed back into place or tied off and removed. The patch decreases the tension on the weakened belly wall. This reduces the risk that a hernia will come back.

What To Expect

Most people who have open hernia repair surgery are able to go home the same day. Recovery time is about 3 weeks.

You most likely can return to light activity after 3 weeks. Strenuous exercise should wait until after 6 weeks of recovery.

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 didn't work. To reduce swelling and pain, put ice or a cold pack on the area for 10 to 20 minutes at a time. Do this every 1 to 2 hours. Put a thin cloth between the ice and your skin.

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Why It Is Done

Surgical repair is recommended for inguinal hernias that are causing pain or other symptoms and for hernias that are incarcerated or strangulated. Surgery is always recommended for inguinal hernias in children. Infants and children usually have open surgery to repair this type of hernia.

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How Well It Works

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 that a hernia needs more than one repair also depends on your age and overall health.

Risks

Adults and children who have a hernia repair are at risk for:

• Reaction to anesthesia (main risk).
• Infection and bleeding at the site.
• Nerve damage, numbness of skin, loss of blood supply to scrotum or testicles causing testicular atrophy (all infrequent).
• Damage to the cord that carries sperm from the testicles to the penis (vas deferens). This can make you unable to father children.
• Damage to the femoral artery or vein.