How is a hernia treated?

Dr. Jeanne Morrison, PhD
Family Practitioner

Abdominal wall hernias are treated with surgery to reduce the hernia and repair the abdominal opening. If a hernia is asymptomatic, surgery can often be delayed. There are two main types of hernia surgery—herniorrhaphy and laparoscopy. Herniorrhaphy is a traditional surgery that uses a single long incision and stitches to repair the opening. Laparoscopic surgery is another option, which uses several small incisions and a tiny camera to reach and repair the hernia. Hernioplasty, which can be used with either type of surgery, uses a synthetic mesh patch to strengthen and close the hernia opening.

Dr. Michael A. Perez, MD
Colorectal Surgeon

For hernia treatment, patients with hernias should be referred to appropriately trained surgeons to assess the feasibility of minimally invasive hernia repair. Minimally invasive surgery involves laparoscopic techniques and robotic assistance may be appropriate as well. Over 600,000 hernias are repaired annually in the United States alone, the majority on an outpatient basis.

There is no adequate nonsurgical medical treatment for a hernia. Under certain circumstances the hernia may be watched and followed closely by a physician. These situations are unique to those individuals who are at high risk for operation.

Minimally invasive hernia surgery has been perfected in the past two decades. The goals are to reduce pain, improve outcomes, and reduce the time of recovery.

The principles of surgical repair involve the use of prosthetic mesh to repair defects in order to minimize tension on the repair. A tension free repair has a lesser chance of hernia recurrence. In addition the risk of infection is markedly decreased compared to traditional open hernia repair. In fact, for inguinal hernia repairs, doctors can even perform the dissection in the extraperitoneal space, avoiding any intra-abdominal adhesions.

For all types of minimally invasive hernia repairs, patients are able to return to normal activity much faster. With minimally invasive inguinal hernia repairs, patients can even return to full athletic activity within one to two weeks.

A hernia occurs when part of an internal organ or body part protrudes through an opening into another area where it ordinarily should not be located. There are many different types of hernias. A transmesenteric hernia is a type of internal abdominal hernia. These hernias are rare and more difficult to diagnose. Although not all hernias need to be operated on, hernias that cause symptoms or that become larger should be repaired by a surgeon. Significant pain at the site of a hernia can be the first sign that it is incarcerated or strangulated.

There are several different treatment options for hernias.  If you do not have any symptoms with a hernia, you may not need any treatment.

Nonsurgical treatment options include supportive undergarments (hernia trusses or abdominal binders) that you wear to help keep a hernia from sticking out or getting bigger.

Surgery is the most common treatment option. The current recommended best therapy for repair is to close the hole made by the hernia, and then add a mesh to secure it. Adding mesh lowers your risk of recurrence to less than 8%. Without mesh, the chance of the hernia returning increases to 30%.

Hernia repair surgery may be done in three different ways.

  • Open surgery repair has been performed since the 1800s.
  • Laparoscopic hernia repair began in the early 1980s. It uses smaller incisions and offers a faster recovery. Use may be limited with ventral, incisional and umbilical hernias. Only small defects can be closed before a mesh is applied. Usually, with this method, a mesh is placed without actually closing the defect.
  • Robotic repair is the latest technology in hernia repair. It allows doctors to close much larger hernias before placing a mesh. This method follows the current recommended best therapy for hernia repair.

Different hernias have different treatments. Inguinal hernias are treated in several different ways. There's a laparoscopic treatment, where doctors put small incisions in the abdomen, blow the belly up full of air, and put a camera inside. While looking at the hernia from the inside, doctors put a mesh patch over the defect to keep the organs from protruding out through the muscle wall.

This also can be done in a minimally invasive manner with robotic surgery. Or, it can be performed in an old-fashioned, traditional approach, with a small incision on the anterior abdomen. Doctors can cut down directly to the muscle tear, sew that up and put a mesh patch right over the top of it to help reinforce it.

Continue Learning about Hernia Treatment

How do medications treat a hernia?
Honor Society of Nursing (STTI)Honor Society of Nursing (STTI)
Abdominal wall hernias cannot be treated with medication because they cannot repair an abdominal wal...
More Answers
How long will my mesh repair hernia surgery last?
TriStar StoneCrest Medical CenterTriStar StoneCrest Medical Center
How long your hernia surgery lasts depends on the type of hernia you have, the type of surgery (lapa...
More Answers
What limitations will I have after a hernia repair?
TriStar StoneCrest Medical CenterTriStar StoneCrest Medical Center
Limitations after hernia surgery are necessary to allow for healing and prevent complications. The m...
More Answers
Should all hernias be repaired?
TriStar Greenview Regional HospitalTriStar Greenview Regional Hospital
Hernias always require surgical repair at some point. The only issue is the urgency of the repair. T...
More Answers

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.