Herniorrhaphy

Medically reviewed by Andrew Gonzalez MD, JD, MPH on September 11, 2017Written by Becky Young on September 11, 2017

Overview

A herniorrhaphy refers to the surgical repair of a hernia, in which a surgeon repairs the weakness in your abdominal wall. A hernia occurs when a weak area in the muscles of your abdominal wall allows an internal part of your body to push through.

If you have a direct hernia, which bulges from your abdominal wall, the surgeon will push the bulge back where it belongs and then repair the weak spot in your muscle wall by stitching the edges of the healthy muscle tissue together. When the area of muscle to be repaired is large, surgeons may sew a synthetic mesh over it to reinforce it. This procedure is referred to as a hernioplasty.

The chance of a hernia recurring following surgery is low. The likelihood of reoccurrence varies based on the type of hernia and the surgical procedure. Prior to the introduction of mesh, hernias reappeared in roughly 15 percent of people who underwent surgery. The use of mesh has reduced this number.

Surgery procedure

Prior to the procedure, your doctor will need to conduct a full examination to confirm that you have a hernia. Let your doctor know if you smoke, have a history of blood clots, or are taking blood thinners or large doses of aspirin.

Hernia repair may be accomplished either in an open fashion or laparoscopically (key-hole surgery). While the chances of recurrence are similar with either technique, post-operative pain is less with laparoscopic surgery.

The steps of the procedure itself are as follows:

  1. You will be given a local or general anaesthetic depending upon the specifics of the surgery.
  2. Following anaesthesia, you may need to be shaved to expose the skin.
  3. An incision will then be made parallel to the line of your inguinal ligament.
  4. Once the hernia sac has been identified, the surgeon will place the protruding organs back into place and then either stitch your abdominal wall or insert the mesh for larger areas.
  5. They will then close their original incision and apply a suitable dressing.

You will usually be able to return home on the day of the procedure, but you must rest and you won’t be able to drive for about two weeks. You should make arrangements to be collected from the hospital.

Recovery

It takes around three weeks to recover from a herniorrhaphy. You should be able to carry out light activities and have sexual intercourse after this time. Strenuous activity should not be undertaken until at least six weeks after the operation. To decrease your risk of hernia recurrence, most surgeons recommend not lifting any weight greater than a gallon of milk for between two to six weeks.

Some swelling is common at the site of the incision following a herniorrhaphy. It should reduce with time and is not an indication that the surgery hasn’t been successful. In order to reduce any pain and swelling, place a clean, thin cloth over the area and apply some ice or a cold pack for around 20 minutes. This can be done every couple of hours.

Contact your doctor if:

  • you develop a fever
  • the incision becomes red and warm
  • the incision is bleeding through your dressing

Cost

The average cost for a herniorrhaphy is between $4,200 and $6,200. Families with insurance will usually have about a $1000 deductible to meet each year before their provider will cover the procedure.

Possible risks and complications

As with any surgical procedure that requires anaesthesia, there are risks involved. They include:

  • negative reaction to anaesthetic
  • infection or bleeding at site of incision
  • nerve damage
  • numbness of the skin
  • testicular atrophy in men
  • damage to the vas deferens in men
  • mesh infection
  • damage to intra-abdominal organs

Outlook

The outlook for those requiring a herniorrhaphy is generally good if the hernia is diagnosed and repaired promptly. The prognosis will depend upon the size and type of the hernia.

A small percentage of herniorrhaphy procedures are carried out as emergencies. In these cases, the hernia has usually been ignored, which has led to strangulation of the hernia or a blockage in the intestines.

Surgery is currently considered the only option for treatment, but surgery for recurrent hernias is often less successful than the initial surgery.

Assuming your surgery has gone well and you do not develop any complications, you should be fully recovered within six weeks.

CMS Id: 131599