Open Inguinal Hernia Repair
An inguinal hernia occurs when a small portion of bowel bulges out through the inguinal canal into the groin. The bulge usually contains tissue lining the inside of the abdomen and may include fatty tissue from the abdomen or a loop of intestines. There are 2 types of inguinal hernias:
- Direct inguinal hernias occur when a weak spot develops in the lower abdominal muscles. Often the cause of the hernia is not known, but lifting, straining, coughing, excessive weight gain, pregnancy, or constipation are often thought to cause a hernia.
- Indirect inguinal hernias occur when the inguinal canal fails to close before birth. The hernia may appear in the male’s scrotum or in the fold of skin at the opening of a female’s vagina. This is the most common type of inguinal hernia, and it may occur at birth or later in life. Indirect hernias are more common in males.
Symptoms of an inguinal hernia may come on gradually or suddenly and may include a bulge in the groin or scrotum and discomfort, pain, or a feeling of heaviness. Other symptoms may develop if tissue in the hernia becomes trapped (incarcerated) or if the blood supply to the trapped tissue is cut off (strangulation).
The open surgical repair of an inguinal hernia is usually done under local anesthesia. The patient is brought into the operating room and an anesthesiologist administers I.V. medication to sedate the patient. The surgical site is then injected with local anesthetic to numb the area. An incision (21/2 inches) is made in the groin. If the hernia is bulging out of the abdominal wall, the bulge is pushed back into the abdomen. The weak spit in the muscle wall-where the hernia bulges through-is closed by placing mesh over the opening. Mesh patches of synthetic material (Gore-Tex, Dacron, Marlex, or Prolene) are now being used to repair the hernia. The patch strengthens the abdominal wall, reducing the risk a hernia will recur. The recurrence risk is about 1-3%.
- The hernia can recur following any hernia surgery. The recurrence rate after a mesh repair is 1-3 %.
- Injury to bowl if it is in the hernia sack
- Injury to the spermatic cord. If the blood supply is injured one could have atrophy of the tactical.
- Pain or numbness if scar tissue develops around the nerve or the nerve is injured.
Most hernia operations are performed on an outpatient basis, meaning the patient will go home the same day that the operation is performed.
You should shower the night before or the morning of the operation.
If you have difficulties moving your bowels, an enema or similar preparation should be used after consulting with your surgeon.
Some preoperative testing may be required depending on your medical condition and the type of anesthesia needed for your operation.
If you take medication of a daily basis, discuss this with your surgeon as (s)he may want you to take some of your medications on the morning of surgery with a sip of water. If you take aspirin, blood thinner or arthritic medication you should discuss with your surgeon the proper timing of discontinuing some medications before your operation.
Following the operation, you will be transferred to the recovery room where you will be monitored carefully until you are fully awake.
Once you are awake and able to walk, you will be discharged.
With any hernia operation, you can expect some pain, this will be mostly during the first 24 to 72 hours. Pain prescriptions will be given to take home.
Most patients are off work for 1 week. You may go back sooner if you feel up to it. The only restriction is no heavy lift (>20 lbs.) for 2 weeks.A friend or family member will need to take you home the day of surgery.
You are encouraged to be up and about the day after surgery.
If you begin to have fever, chills, vomiting, are unable to urinate, or experience drainage from your incision, you should call your surgeon immediately.
If you have prolonged soreness and are getting no relief form the prescribed pain medication, you should notify your surgeon.
You should call and schedule a follow-up appointment within 2 weeks after your operation.