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Treatments and drugs
By Mayo Clinic staffIf your hernia is small and isn't bothering you, your doctor may recommend a watch-and-wait approach. But enlarging or painful hernias usually require surgical repair to relieve discomfort and prevent serious complications. There are two general types of hernia operations:
- Herniorrhaphy. In this procedure, also called "open" hernia repair, your surgeon makes an incision in your groin and pushes the protruding intestine back into your abdomen. Then your surgeon repairs the weakened or torn muscle by sewing it together. Often the weak area is also reinforced and supported with a synthetic mesh, a procedure called hernioplasty. After the operation, you'll be encouraged to move about as soon as possible, but it may be as long as four to six weeks before you're able to fully resume your normal activities.
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Laparoscopy. In laparoscopic surgery, your surgeon uses several small incisions rather than one large one. A fiber-optic tube with a tiny camera is inserted into your abdomen through one incision, and miniature instruments are inserted through the other incisions. Your surgeon then performs the operation using the video camera as a guide. In laparoscopic surgery, synthetic mesh is always used to repair the hernia (hernioplasty).
Advantages of laparoscopic repair include less discomfort and scarring after surgery and a quicker return to normal activities — most people are back to work within a few days. The procedure is a good choice for people whose hernias recur following traditional hernia surgery because laparoscopic methods allow surgeons to work around scar tissue from earlier repair. It's also good for people who have hernias on both sides of the body (bilateral inguinal hernias).
Disadvantages of laparoscopic repair include an increased risk of complications and of recurrence following surgery. These risks are reduced if the procedure is performed by a surgeon with extensive experience in these kinds of repairs.
You may not be a candidate for laparoscopic hernia repair if you have a very large hernia, if your intestine is pushed down into the scrotum or if you've had previous pelvic surgery such as a prostatectomy.
- Inguinal hernia. National Digestive Diseases Information Clearinghouse. http://digestive.niddk.nih.gov/ddiseases/pubs/inguinalhernia. Accessed Sept. 30, 2010.
- Patient information for laparoscopic inguinal hernia repair from SAGES. Society of American Gastrointestinal and Endoscopic Surgeons. http://www.sages.org/sagespublication.php?doc=PI06. Accessed Sept. 30, 2010.
- Dedemadi G, et al. Laparoscopic versus open mesh repair for recurrent inguinal hernia: A meta-analysis of outcomes. The American Journal of Surgery. 2010;200:291.
- Ramsook C, et al. Overview of inguinal hernia in children. http://www.uptodate.com/home/index.html. Accessed Sept. 30, 2010.
- Ramsook C, et al. Overview of treatment for inguinal and femoral hernias. http://www.uptodate.com/home/index.html. Accessed Sept. 30, 2010.
- Ramsook C, et al. Classification and diagnosis of inguinal and femoral hernias. http://www.uptodate.com/home/index.html. Accessed Sept. 30, 2010.
- Goroll AH, et al. Approach to the patient with an external hernia. In: Goroll AH, et al. Primary Care Medicine. 5th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008:496.
- Matthews RD, et al. Inguinal hernia in the 21st century: An evidence-based review. Current Problems in Surgery. 2008;45:261.
- Jenkins JT, et al. Inguinal hernias. British Medical Journal. 2008;336:269.
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