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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. Enlarging or painful hernias usually require surgery to relieve discomfort and prevent serious complications.
There are two general types of hernia operations — open hernia repair and laparoscopic repair.
Herniorrhaphy
In this procedure, also called an open hernia repair, the surgeon makes an incision in your groin and pushes the protruding omentum or intestine back into your abdomen. The surgeon then sews together the weakened or torn muscle. The weak area often is reinforced and supported with a synthetic mesh (hernioplasty).
After the surgery, you'll be encouraged to move about as soon as possible, but it may be four to six weeks before you're fully able to resume your normal activities.
Laparoscopy
In this minimally invasive procedure, the surgeon operates through several small incisions in your abdomen. A small tube equipped with a tiny camera (laparoscope) is inserted into one incision. Guided by the camera, the surgeon inserts tiny instruments through another incision to repair the hernia using synthetic mesh.
Most people who have laparoscopic repair experience less discomfort and scarring after surgery and a quicker return to normal activities. Laparoscopy may be a good choice for people whose hernias recur after traditional hernia surgery because it allows the surgeon to avoid scar tissue from the earlier repair. Laparoscopy also may be a good choice for people with hernias on both sides of the body (bilateral inguinal hernias).
Some studies indicate that a laparoscopic repair may have an increased risk of complications and of recurrence following surgery. These risks can be reduced if the procedure is performed by a surgeon with extensive experience in laparoscopic hernia repairs.
Laparoscopic hernia repair may not be for you if:
- You have a very large hernia
- Your intestine is pushed down into the scrotum
- You've had previous pelvic surgery, such as prostate surgery (prostatectomy)
- You can't receive general anesthesia
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Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&isbn=978-1-4160-6189-2&about=true&uniqId=229935664-2192. Accessed Jan. 8, 2013.
- Goroll AH, et al. Primary Care Medicine: Office Evaluation and Management of the Adult Patient. 6th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2009. http://gateway.ovid.com/ovidweb.cgi?T=JS&MODE=ovid&PAGE=main&D=baov&PCOSTART=goroll. Accessed Jan. 8, 2013.
- Inguinal hernia. National Digestive Diseases Information Clearinghouse. http://digestive.niddk.nih.gov/ddiseases/pubs/inguinalhernia/#what. Accessed Jan. 8, 2013.
- Mizrahi H, et al. Management of asymptomatic inguinal hernia: A systematic review of the evidence. Archives of Surgery. 2012;147:277.
- AskMayoExpert. What are the most common types of hernia that occur in children? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- Matthews RD, et al. Inguinal hernia in the 21st century: An evidence-based review. Current Problems in Surgery. 2008;45:261.
- Karthikesalingam A, et al. Meta-analysis of randomized controlled trials comparing laparoscopic with open mesh repair of recurrent inguinal hernia. British Journal of Surgery. 2010;97:4.
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