HERNIA Treatments

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Reviewed By:  Dr. Paul Szotek

Will a hernia heal on it's own?

Our bodies have remarkable regenerative healing capabilities, but sometimes they need a little help.

While watchful waiting may be a viable option for a limited period of time, hernias typically require a surgical procedure to fully repair the defect and reduce the risk of a trip to the emergency room.1

will a hernia heal on its own

I have this bulge, but no pain. Is there a way to hide it?

For decades, properly fitted support garments like hernia belts (truss) or briefs have been effectively used to reduce the visible appearance of a hernia. However, this non-surgical option is a short-term solution and will require a consultation with your doctor to determine proper fit and assessment of your condition. 

hiding bulge hernia belt

Hernia Surgery

A relatively routine procedure with over one million performed each year in the US2, hernias can be repaired either open, laparoscopically, or robotically.

Open-hernia-repair-surgery Open

Surgeon makes a large incision with a scalpel and uses handheld instruments to navigate anatomy and repair the hernia with suture only or a combination of reinforcement material and suture.

Laparoscopic-hernia-repair-surgery Laparoscopic

A few small incisions are made to place ports, which are used to introduce instruments and a 2D camera, providing the surgeon with visibility to repair the hernia with reinforcement material.

Robotic-hernia-repair-surgery Robotic

Similar to laparoscopic with small incisions and ports, the surgeon repairs the hernia by controlling fully articulating robotic instruments from a console that displays a 3D view of the patient’s anatomy.

Know Your Options

Learn more about the surgical approaches used to repair hernias. While each approach has proven clinical benefits, it’s important to understand the limitations and risks.

What hernia repair surgery is right for me?

Use this framework to help evaluate your options.

There are many interconnected factors like anatomical location of the hernia, defect size, medical history, patient preference, surgeon experience, preferred technique, repair material availability, insurance coverage, and procedural cost that must be considered to determine the optimal approach to repair the hernia.

As with any multifactorial decision, each aspect must be thoroughly evaluated logically and supported by clinical evidence because one suggestion or preference could negatively impact the surgical outcome.

How will my body respond?

As no two hernias are the same, every person’s regenerative healing capabilities vary and can be impacted by comorbidities, genetics, diet, and lifestyle.

The amount of foreign material introduced and left behind triggers an inflammatory response, which is an essential part of the natural healing process.3 A prolonged response may lead the body to initiate a defense mechanism that interrupts the regeneration of new tissue, increasing the likelihood of scar tissue formation and potentially leading to recurrence and additional complications.

Surgeon selection

When considering a surgeon, specialty and experience matter. The more experienced surgeons will have a plan A through Z.

Just because someone is local, does not mean they are the right surgeon to repair your hernia. Thanks to telehealth, many patients are able to consult with a surgeon to identify fit and only need to travel for the procedure. 

It's important to find a surgeon who continues to develop their surgical skills so they can confidently offer the latest innovations designed to improve outcomes. 

Find out what is the surgeon’s preferred surgical approach for treating similar hernias. Often times the “best” hernia repair is the one the surgeon performs the most.

Not all surgeons will have access to a robot and if they do, don't be afraid to ask how many procedures they have performed. 

Most importantly, find a surgeon who believes in working together to offer patients repair options based on clinical need, supported by evidence, and without bias.

Repair Materials Matter

A misconception many patients have is that a no mesh hernia repair eliminates the risk of complications from foreign bodies. To repair the tissue defect foreign bodies like sutures and tacks are utilized, which are often the same absorbable and permanent polymeric materials hernia meshes are made of.

When used properly, synthetic mesh has been demonstrated effective to repair hernias.4

There are over 150 types of hernia mesh available on the market, which include synthetic, absorbable synthetic, biologic, and hybrids, made of a combination of synthetic and biologic materials.5

Important to ask about the availability of new innovative surgical implants and materials. Your local or regional hospitals may not have access to the latest technology.

Be sure to ask about clinical evidence for any implant or repair material that may be used. Published, peer-reviewed safety and outcomes data can help you and your doctor make an appropriate decision. 

I don’t want hernia mesh – what other options do I have?

Unfortunately, we are starting to see the devastating impact legacy mesh has caused patients and families all over world.

While words will do little to ease the pain and suffering, only positive action by the medical community such as committing to enhance the standard of hernia care through patient empathy, continued education, and leveraging innovative technology supported by clinical evidence will help those affected heal and move forward with the promise of a better tomorrow.

While the word mesh triggers fear and anxiety for many hernia patients, it’s vital to understand the pros and cons of alternative repairs, as very few patients are candidates for a "no mesh" procedure. 

Click here to read about no mesh hernia repair misconceptions. 

Please do not delay treatment, which can lead to severe complications that turn into a medical emergency.

Hernia-repair-options

Prepping for Hernia Surgery

Whether this is your first hernia, or you’ve unfortunately had complications requiring additional procedures, it’s important to work with your health care provider to define a plan which is designed to optimize the best potential surgical outcome and post-op recovery.

Prepping for hernia surgery

The areas of focus include:

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Diet & Nutrition
Diet & Nutrition Help prepare your immune system by eating nutrient rich meals and avoid overly processed foods. Consider taking immunonutrition shakes, available online and at most pharmacies.
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Stop Smoking
Stop Smoking At minimum 6 weeks prior to surgery. Some surgeons may make you take a continine test to confirm. 
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Exercise
Exercise If medically possible, light to moderate exercise such as walking may help strengthen the heart and lungs, which are essential to recovery.  
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Diabetes Management
Diabetes Management Goal is to have your HgbA1C under 7.0 prior to surgery. 
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BMI
BMI Most surgeons target patients to have a BMI of less than 35. If you feel your "high" BMI is beyond your control, you are not alone. You may want to consult a bariatric surgeon who are specialized to offer personalized help.
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Antibacterial Cleanse
Antibacterial Cleanse Recommend bathing with antiseptic soap prior to the procedure and once discharged to help protect against surgical site infections (SSIs). Some surgeons may prescribe antibiotic.  

Hernia Surgery Recovery Guide

Take it slow, with the goal of trying to get better each week. Below is a high-level overview of what you can likely expect with a routine hernia repair. Individual results will vary. Please discuss your recovery timeline with your health care provider.  

  • Week 1 - Use Comfort As Your Guide

    You will likely have discomfort and swelling the day after the procedure, especially when changing positions. Take it slow, and ask your doctor what pain management regimen they recommend.

    If you are sent home with a drain or VAC, please follow your discharge instructions from the hospital. 

    It’s okay to shower the day after surgery. Be mindful of your bandages, and try to keep them dry. Use antibacterial soap. 

    You can use a binder or belly band for 48 hours after surgery. Wearing over a soft t-shirt will help protect skin from irritation.

    You may have some constipation, speak with your doctor if it lasts more than a few days.

    Swelling will likely continue for a few days, especially in the male's scrotum, which is normal. 

  • Week 2 - Start to Move, Stop if You Feel Pain or Discomfort

    At this point, it’s good to get moving, but you don’t want to increase abdominal pressure or strain the muscles.

    Avoid activities like yoga or Pilates – as tensing up abdominals increases pressure.

    Start with a taking a walk, and as you build up stamina, it’s okay to get on a treadmill, elliptical, or stationary bike.

     

     

     

     

  • Week 3 and 4 - Slowly Returning to Normal

    This may be the time you start to return to work and resume normal daily activities. Your abdomen may be ready to experience light twisting and turning – like that of a golf swing.

    At your post op visit, your doctor may also clear you to resume light lifting at the gym or at work.

  • One Month Post Surgery

    Barring any setbacks, you doctor should clear you to return to normal activities. Your abdominal muscles should be healed enough to be able to handle sudden movements like taking your dog for a walk. 

    For complex abdominal wall surgery, recovery can take up to 3 months. Your doctor will work with you to develop a recovery game plan.

Hernia Post Op FAQs

Rather than deal with the anxiety and frustration that comes from asking search engines or social media for medical advice, a collection of leading surgeons answer the most frequently asked questions by hernia patients after their surgery.

Can you lift weights after hernia surgery?

Week 2 is likely when your doctor will recommend light physical activity such as walking or riding a stationary bike. Not recommended to do yoga or pilates as you want to decrease intra-abdominal pressure.

Don’t lift too heavy especially with exercises like deadlifts as that will create significant abdominal pressure. 

Week 3 or 4 you may be cleared to swing a golf club

How long after hernia surgery can I have sex?

Highly recommended waiting until the swelling goes down. Depending on repair material, surgical technique, and your healing progress may be possible to have sex 5-7 days post op.

When should I call my doctor after hernia surgery?

While you may experience swelling, bruising, and minor pain after surgery, please call your doctor if you experience fever, shooting pain, and no bowel movement after three days.

Is this tugging or pulling sensation normal?

Every patient will have a slightly different response to the surgery. While some may feel a tugging or pulling sensation near the incision for a few days post op when they suddenly switch positions, others may notice the feeling weeks or months later. If the sensation is causing persistent discomfort that negatively impacts your quality of life, please contact your doctor.

How long does a drain stay in after hernia surgery?

You may have a drain inserted by your incision, which is designed to help remove excess fluid to aid the healing process and prevent complications like an infection. Depending on the complexity of your procedure, the drain may stay in for a few days. You will receive detailed instructions for drain care at the time of your discharge from the hospital.

How to sleep after hernia surgery?

It really depends on the location of your hernia and your incision sites. It’s advised to wear your binder as much as possible the first few weeks post op. Some patients feel comfortable sleeping in a reclining chair for a few days post-op as that reduces the number of times you have to sit up. Side sleepers may need to use a pillow between your legs to provide additional support.

For patients with both GERD and sleep apnea, you may be at additional risk for a hiatal hernia.6 Consider consulting a bariatric surgeon.

What to eat after hernia surgery?

As it’s important to reduce intra-abdominal pressure after surgery to help the healing process, consider a bland diet for the first week. It is common to temporarily lose your appetite after hernia surgery. 

How long will I be off work after a hernia operation?

Depending on your job and the type of procedure you had, your doctor may clear you to return to work 3-5 days post op. It’s important to listen to your body and don’t exert yourself too much.

How much pain is normal after hernia repair?

It's very common to experience mild to moderate pain after hernia surgery which typically lasts about a week and can be managed with over the counter pain medications. For most patients, your second day post-op may be the most painful. 

Up to 16% of people experience chronic pain following the repair of a groin hernia.7 It’s important to speak to your doctor if the pain is negatively impacting the quality of your life two to three months post surgery. 

Did I mess up my hernia repair?

The number one sign to look for is bulging, swelling, or fullness at the repair site as that may indicate fluid build up. A drain may be inserted to reduce the amount of fluid, which can help prevent infection and further downstream complications like a revision surgery.

Do you lose weight after hernia surgery?

Depending on how your body handles fluid, your weight may fluctuate slightly after hernia surgery.

You may experience a decrease in appetite that should last a few days. Depending on your BMI, your doctor may recommend once you are cleared a diet and exercise regimen which is important for minimizing the chance of hernia recurrence. 

What are the symptoms of hernia mesh rejection?

If you are experiencing persistent flu like symptoms such as a high fever, nausea, and vomiting in addition to  difficulty passing gas or stool you may be showing symptoms of a mesh rejection.  Other symptoms include redness around the repair site and abdominal stiffness or a hard lump. Please seek medical attention immediately.

Need help sharing your fears and concerns with your doctor?

Use our SCAFFOLD Guide to help bridge the communication gap.

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References: 

1. Fitzgibbons RJ Jr, Ramanan B, Arya S, et al. Long-term results of a randomized controlled trial of a nonoperative strategy (watchful waiting) for men with minimally symptomatic inguinal hernias. Ann Surg. 2013;258(3):508-515. doi:10.1097/SLA.0b013e3182a19725 

2. Retrieved from https://www.fda.gov/medical-devices/implants-and-prosthetics/hernia-surgical-mesh-implants 

3. Kokotovic, D., Burcharth, J., Helgstrand, F. et al. Systemic inflammatory response after hernia repair: a systematic review. Langenbecks Arch Surg 402, 1023–1037 (2017). https://doi.org/10.1007/s00423-017-1618-1

4.Harris HW, Primus F, Young C, et al. Preventing Recurrence in Clean and Contaminated Hernias Using Biologic Versus Synthetic Mesh in Ventral Hernia Repair: The PRICE Randomized Clinical Trial. Ann Surg. 2021;273(4):648-655. doi:10.1097/SLA.0000000000004336 

5. Russo Serafini, Mairim, et al. "The Patenting and Technological Trends in Hernia Mesh Implants." Tissue Engineering Part B: Reviews 27.1 (2021): 48-73. 

6. Peter J. Kahrilas, Obstructive Sleep Apnea and Reflux Disease: Bedfellows at Best, Chest, Volume 137, Issue 4, 2010, Pages 747-748, ISSN 0012-3692, https://doi.org/10.1378/chest.09-2496.

7. Andresen K, Rosenberg J. Management of chronic pain after hernia repair. J Pain Res. 2018;11:675-681. Published 2018 Apr 5. doi:10.2147/JPR.S127820