Hernia Repair Surgery and Different Types

Ever had any of your family members show these symptoms? Unexplained pain near the stomach region with severe acid reflux or pain in the groin region with difficulty lifting heavy items. A bulging belly button in an adult or baby that can sometimes cause pain. All these are signs and symptoms of different types of hernia. A hernia is most often described as the bulging of a tissue that pushes through organs putting a lot of pressure. This health condition is explained quite well with the analogy of a bulging portion of a damaged tire. Similarly, the tissue squeezes through a weak point and stays so, causing pain and discomfort that may hinder normal activities.

The good news is that you do not have to battle a hernia forever. Hernia repair is a common medical procedure done to put the protruding tissue in its place or remove it off. This procedure is also referred to as herniorrhaphy. Let’s take a look at the types of hernias and the treatment options.

Types of hernia:

• Hiatus Hernia

This type of hernia occurs when a portion of the stomach pushes into the diaphragm and into the chest. In a healthy person, the stomach stays below the diaphragm causing no stomach acid to enter the diaphragm.  However, a person with hiatal hernia would experience acid reflux or GERD (Gastroesophageal Reflux Disease). Shortness of breath, indigestion, difficulty in swallowing food and abdominal pain are other symptoms.

Hiatal Hernia Repair

To cure or treat hiatal hernia, the doctor would pull down the stomach and decrease the opening of the diaphragm. As the first step, often medications are given to the person to reduce symptoms and help in healing of the hernia. If there are more serious symptoms such as ulcers, bleeding, black stools, scarring of the stomach walls and others, surgery would be the only option.

Surgery can be of three types. An open surgery or incisional hernia repair where the doctor would make a large incision at the site to rectify the hernia is one. A laparoscopic hiatal hernia repair will be done and the surgeon will make close to 3 or more incisions in the abdominal region. Endoluminal Fundoplication is another latest technique where an endoscope is fitted with camera and clips and the hernia is closed by means of these clips. In this case there will be no incisions since the procedure is done through the mouth using the endoscope. Sometimes, patients would also prefer an additional procedure such as sleeve gastrectomy for weight-loss, along with hiatal hernia repair.

• Umbilical Hernia

In some people, the belly button appears bulging out or swollen. This can happen at any age and is most common among babies and women (especially during and after pregnancy). Weakness around the muscles of the navel causes it to bulge out. Fever, abdominal pain, constipation, nausea and tenderness in the stomach are some of the common symptoms.

Umbilical Hernia Repair

 If the umbilical hernia is on a child, doctors recommend waiting till 5 years of age to decide on surgery. If the hernia is not painful and is not increasing in size, it would ideally subside in a few years time. However, surgery might be required in adults as it might not always go off on its own and puts pressure on surrounding tissues. This could cause severe discomfort to the patient and might only aggravate with time. A surgery would be the long lasting solution for curing umbilical hernia. The doctor would push down the outgrown tissue back into the abdomen. Sutures are done post-surgery and in some cases a mesh might be placed before stitching. Umbilical hernia repair with mesh is usually preferred for adults.

• Inguinal Hernia

Inguinal hernia is also called groin hernia. This type of hernia is caused when a part of the intestine pushes through a weak point in the abdominal wall. A visible bulge might be felt when seen or touched and the patient can easily understand the presence of hernia. It might be difficult to observe this on obese people. Individuals might find it difficult to bend, cough or lift heavy things if they suffer from groin hernia.

Inguinal Hernia Repair

Open surgery is one way of treating an inguinal hernia repair where the doctor will make an incision in the area of the hernia and gently push back the tissue into the abdominal wall. A laparoscopic inguinal hernia repair can also be done. 

• Ventral Hernia

Ventral hernia can appear anywhere at the abdominal region, causing pain and a lump like feeling on touching. Usually these occur in areas where a past surgery has been done. Pain, discomfort, nausea is some of the symptoms.

A ventral hernia repair surgery would be the best solution. Open surgery or laparoscopic surgeries can be done and in some cases a mesh is placed.

• Femoral Hernia

Femoral hernia occurs in the groin and inner thigh region where the tissue would protrude and a lump can be felt on touch. Pain, discomfort, swelling and nausea are common symptoms. Open femoral hernia repair or a laparoscopic surgery might be needed to resolve the condition.

• Parastomal Hernia

In patients with gastrointestinal diseases, a stoma (a surgical opening in the colon or stomach) might be used. A parastomal hernia is a condition where the tissue bulges out of a stoma. Parastomal hernia repair by means of a surgery is important to heal the condition.

• Epigastric Hernia

In this type of hernia, fat tissues protrude through the abdominal wall and cause a lump. Usually, epigastric hernia appears above the belly button region. Pain, difficulty in sneezing or coughing, constipation and uneasiness are the most common symptoms. Epigastric hernia repair is done using open hernia repair or the laparoscopic technique.

Most of hernia repair procedures take about 45 minutes to one hour for completion. The recovery period from surgery for most of the types of hernia is 2 to 3 weeks. A person can get back to strenuous activities only after 6 weeks and appropriate care must be taken. The results of a hernia repair surgery could last a lifetime for most patients, giving relief to most discomforts and symptoms caused by the disease. 

Since hernia does not go away with time, it is important for patients to consult a doctor. Depending on the stage of the hernia, a doctor would be able to guide appropriately on the treatment needed. The cost of a hernia repair surgery might vary between INR 60k to 2 lakhs depending on the type of surgery opted, the location and clinic of choice.

Frequently Asked Questions:

1. What are the different types of hernia surgery?

The main types of hernia surgery include:

Open Surgery / Invasive Hernia Repair: The doctor makes a large incision to correct the hernia

Laparoscopic Surgery: Smaller incisions of 3 to 5 are made to correct the hernia

Endoscopic hernia repair: In the case of hiatal hernia, an endoscope with camera is used to treat the hernia through the mouth.

Robotic Surgery: This is a type of surgery where the surgeon uses surgical instrument from a console and performs the surgery.

2. What is the best hernia repair method?

The best hernia repair method can be decided based on the type of hernia. An open surgery is often considered better than a laparoscopic surgery for inguinal hernia. Laparoscopic surgery is also very effective with minimal invasive surgery and faster recovery. Robotic surgeries are also one of the leading ways of treating hernia with very minimal risk on the patient. There is lesser blood loss, tissue damage and infections with the newer techniques.

3. What are the options for hernia repair?

Open surgery, laparoscopic surgery, using mesh that are made of synthetic polymers are the most common treatment options for hernia repair.

4. Which is better open or laparoscopic hernia repair?

Laparoscopic surgery is considered better than open surgery since it reduces the risk of infections, blood loss and tissue damage. There is also a higher chance of recovery and better healing with lesser invasive procedures.

5. How do you poop after hernia surgery?

It is important to not apply too much pressure on your abdomen post the hernia repair surgery. it is important to have diet rich in fiber and have plenty of water to keep the stool soft. In case of constipation, a doctor might prescribe a stool softener.

6. Is hernia surgery considered major surgery?

Yes, a hernia repair surgery is a major procedure and comes with complications and risk. Though it is a commonly performed procedure, it must be considered based on the individual’s health condition and risk factors.

7. Why is my stomach bigger after hernia surgery?

Swelling after a surgery is a common response of the body. The stomach might look bigger after a hernia surgery because of this swelling but would subside on its own.

8. Is a hernia surgery serious?

Tough a very safe procedure, it is a major procedure.

9. How long is recovery from hernia surgery?

A patient might take around 3 weeks to get healed from a hernia surgery. In a period of 6 weeks, the patient can get back to doing exercises like before.

10. How is a hernia repaired?

Hernia is repaired by pushing the protruding tissue back into the abdominal region. In some cases the protruding tissue could also be removed.

11. Can a hernia heal on its own?

Hernia cannot heal on its own and it is important to get it treated to prevent complications.

12. Is walking good for hernia?

Yes, walking is considered safe for a hernia.

13. Is hernia mesh safe now?

Yes, mesh is safe and is often needed depending on the severity of the hernia.

14. What foods should I avoid with inguinal hernia?

It is important to take healthy food with inguinal hernia. In order to prevent constipation, one must avoid dairy products, processed food and red meat.

15. Can I push to poop after hernia surgery?

It is important to not strain while pooping after a hernia surgery. Individuals might need 1 to 10 days to get back regular bowel movements and must stick to the medications suggested by the doctor.

16. What is the fastest way to recover from hernia surgery?

Proper rest, nutritious food, light exercises are the best way to help the area heal and recover faster.

17. What happens if a hernia is left untreated?

Hernia can get bigger and cause more problems if left untreated. In some cases, it can also be life-threatening if left untreated.

18. Is it OK to run with inguinal hernia?

As long as the hernia does not cause pain and discomfort, a person can continue running. Advice from a doctor would be best in these cases.

19. Do and don'ts after hernia surgery?

Patients must take enough rest, nutritious food (low on diary, meat and oils), medications and drink plenty of water. Strenuous exercises must be avoided until complete recovery. Patients must stay away from smoking and alcohol consumption for a good duration (preferably 4 weeks) before and after the procedure.  

20. Can you live with a hernia without surgery?

Since hernia does not go away on its own, a surgery would be the only solution. Individuals with mild cases of hernia might not need a surgery at all. Many could also delay their surgeries by a few months or years depending on the severity of their hernia.