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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, your surgeon makes an incision in your groin and pushes the protruding intestine back into your abdomen, then repairs the weakened or torn muscle by sewing it together. 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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Hernioplasty. In this procedure, which is something like patching a tire, your surgeon inserts a piece of synthetic mesh to cover the entire inguinal area, including all potential hernia openings. The patch is usually secured with sutures, clips or staples. Hernioplasty can be performed conventionally, with a single long incision over the hernia. But it's often done laparoscopically, using 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.
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.
- Brooks DC. Classification and development of groin hernias. http://www.uptodate.com/home/index.html. Accessed Aug. 20, 2008.
- Inguinal hernia. National Digestive Diseases Clearinghouse. http://digestive.niddk.nih.gov/ddiseases/pubs/inguinalhernia/index.htm. Accessed Aug. 20, 2008.
- Brooks DC. Treatment of groin hernias. http://www.uptodate.com/home/index.html. Accessed Aug. 20, 2008.
- Inguinal hernia. Merck Manuals Online Medical Library. http://www.merck.com/mmhe/sec21/ch238/ch238j.html. Accessed Aug. 20, 2008.
- Patient information for laparoscopic inguinal hernia repair from SAGES. Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). http://www.sages.org/publication/id/PI06/. Accessed Aug. 20, 2008.
- Ramsook C, et al. Overview of inguinal hernia in children. http://www.uptodate.com/home/index.html. Accessed Aug. 20, 2008.
