Surgically Treating Hernias
Most hernias can be diagnosed with a physical exam. Some hernias may require tests such as a CT scan, an ultrasound, or even an MRI for diagnosis. Your surgical team will help guide you through the evaluation period and let you know which tests will be required to evaluate your hernia.
Surgery to Treat Hernias
Surgery is the only treatment that can permanently fix a hernia. Surgery may be more risky for patients who have serious medical problems. If the hernia is small and not causing any problems, you and your surgeon may decide to watch the hernia for several months or more to make sure it is not growing.
Usually, surgery is necessary when hernias:
- Are getting larger
- Are painful
- Cannot be reduced (pushed back inside) without surgery
- May involve a trapped piece of bowel
Surgery secures the weakened abdominal wall tissue and closes any holes. Today, most hernias are closed with mesh material to repair the hole and reinforce the weakened tissue surrounding the hernia.
Sometimes, emergency surgery is needed. If a hernia becomes stuck and can't be pushed back in, the blood supply to whatever is inside the hernia sac can be cut off. Left untreated, this portion of the intestine dies and patients can become very sick and even die.
In rare cases, inguinal hernia repair can damage structures involved in the function of a man’s testicles. Another risk of hernia surgery is nerve damage, which can lead to numbness in the groin area. Your surgeon can tell you more about the risks of hernia surgery, as well as the risks of deciding not to proceed with repair of your hernia.
Minimally Invasive Treatment Options
Medical College of Wisconsin surgeons use the latest techniques to treat inguinal hernias, including totally extraperitoneal (TEP) or transabdominal pre-peritoneal (TAPP) laparoscopic repairs for primary (never before repaired), bilateral (occurring on both sides, in each groin) and recurrent hernias.
Abdominal (ventral) and incisional hernias are treated with traditional and minimally invasive methods, including laparoscopic component separation (a technique for repair of large and complicated hernias where the different layers of the abdominal wall are dissected away from each other and the hernia is then repaired layer by layer) and abdominal wall reconstruction. We choose from a variety of mesh materials when performing repairs and reconstructions, including the latest biologic grafts.
The type of treatment is decided by each patient’s quality of life and daily activity needs, and is based on the latest evidence-based data.
Whenever possible, we offer a minimally invasive hernia repair. While some types of hernias do not allow for this approach, a minimally invasive approach offers faster recovery, faster return to full function and work with less risk of complications, particularly wound infections.
Note: Many thousands of hernia repair operations occur each year with and without surgical mesh, and patients generally recover quickly and do well post-surgery. As with any surgical procedure, complications are possible. You should discuss all your options and their risks and benefits for your individual situation with your health care provider.