How is Open Hernia Repair Surgery Done?
Surgical treatment
The type of operation depends on umbilical hernia size and location and if it is a repeat hernia (recurrence). Your health, age, and the surgeon’s expertise are also important. An operation is the only treatment for a hernia repair.
Your hernia can be repaired with three surgical procedures: open hernia repair surgery, laparoscopic hernia repair surgery, or robotic hernia repair surgery.
Open hernia repair
The surgeon makes an incision near the hernia site, and the bulging tissue is gently pushed back into the abdomen. Sutures or mesh are used to close the muscle.
- For a suture-only repair: The hernia sac is removed. Then the tissue along the muscle edge is sewn together. The umbilicus is then fixed back to the muscle. This procedure is often used for small defects.
- For an open mesh repair, the hernia sac is removed. Mesh is placed beneath the hernia site. The mesh Is attached using sutures sewn into the stronger tissue surrounding the hernia. The mesh extends 3 to 4 cm beyond the edges of the hernia. The umbilicus is fixed back to the muscle. Mesh Is often used for large hernia repairs and reduces the risk that the hernia will come back again.
- For all open repairs, the skin site is closed using sutures, staples, or surgical glue.
- An open repair may be done with local anesthesia and sedation given through an IV.
Open versus laparoscopic hernia repair
There is no significant evidence on the best technique to repair an umbilical hernia, and more study is needed. The type of repair may also depend on the size of the hernia.
- When comparing open mesh repair with laparoscopic mesh repair, there is no difference in the length of hospital stay or recurrence rate. There is a slightly lower wound complication rate, including seromas, hematomas, and infection, with laparoscopic repair. Both types of operations have similar long-term results.
- Open repairs can be done with local anesthesia instead of general anesthesia and are frequently done as outpatient procedures.
- Strangulated hernias may have to be repaired as an open approach.
- The use of mesh provides a stronger repair and decreases the recurrence rate.
- Suture repair will result in a small incision around the hernia site. Laparoscopic repairs usually have 3 to 4 smaller scars at the site of the entry ports.
After the surgery
Most patients will be able to go home a few hours after the open hernia surgery and feel fine within a few days. However, strenuous activity and exercise are restricted for four to six weeks after the surgery.
Benefits and risks of your operation
Benefits – Operation is the only way to repair a hernia. You can return to your normal activities and, in most cases, will not have further discomfort.
Risks of not having an operation—Your hernia may cause pain and increase in size. If your intestine becomes squeezed in the hernia pouch, you will have sudden pain, vomiting and require an immediate operation.
Possible risks include a return of the hernia; infection; injury to the bladder, blood vessels, intestines, or nerves; and continued pain at the hernia site.
Wound care
- Always wash your hands before and after touching near your incision site.
- Do not soak in a bathtub until your stitches, Steri-Strips, or staples are removed. You may take a shower after the second postoperative day unless you are told not to.
- Follow your surgeon’s instructions on when to change your bandages.
- A small amount of drainage from the incision is normal. If the dressing is soaked with blood, call your surgeon.
- If you have Steri-Strips in place, they will fall off in 7 to 10 days.
- If you have a glue-like covering over the incision, allow the glue to flake off on its own.
- Avoid wearing tight or rough clothing. It may rub against your incisions and make it harder for them to heal.
- Protect the new skin, especially from the sun. The sun can burn and cause darker scarring.
- Your scar will heal in about 4 to 6 weeks and will become softer and continue to fade over the next year.
