Inguinal hernia repair

Surgery has generally been advised for all inguinal hernias. It helps avoid complications such as strangulation.

If a hernia in an adult can be pushed back (reduced), surgery doesn't have to be done right away. If the hernia can't be pushed back, surgery must be done sooner. But surgery may not be needed if the hernia is small and you don't have symptoms.

The two types of surgery done to repair inguinal hernias are:

• Open inguinal hernia repair (herniorrhaphy, hernioplasty).
• Laparoscopic inguinal hernia repair.

Most hernias that come back do so within 5 years after surgery.

The risk that a hernia will come back after surgery depends on the surgeon's experience, the type of hernia, and whether mesh is used. It also depends on your age and overall health.

• The chance that a hernia will come back after surgery ranges from 1 to 10 out of 100 surgeries done.
• Using mesh to repair the weak muscle in the belly wall decreases the chance that the hernia will come back by more than half.

The risk of the hernia coming back may be higher if your belly muscles aren't strong or healthy enough to "hold" the stitching (suture) material. The risk is also higher if you have bleeding or infection that weakens the repair.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Activity

• Rest when you feel tired.
• You may shower 24 to 48 hours after surgery, if your doctor okays it. Pat the incision dry. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.
• Allow the area to heal. Don't move quickly or lift anything heavy until you are feeling better.
• Be active. Walking is a good choice.
• You most likely can return to light activity after 1 to 3 weeks, depending on the type of surgery you had.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• If your bowel movements are not regular right after surgery, try to avoid constipation and straining. Drink plenty of water. Your doctor may suggest fiber, a stool softener, or a mild laxative.

Medicines

• Be safe with medicines. Read and follow all instructions on the label.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.

Incision care

• You will have a dressing over the cut (incision). A dressing helps the cut heal and protects it. Your doctor will tell you how to take care of this.
• If you have skin adhesive on the cut, leave it on until it falls off. Skin adhesive is also called liquid stitches or glue.
• If you have strips of tape on the cut, leave the tape on for a week or until it falls off.
• If you had stitches, your doctor will tell you when to come back to have them removed.
• Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol. They can slow healing.

Ice

• Put ice or a cold pack on the area for 10 to 20 minutes at a time. Try to do this every 1 to 2 hours for the next 3 days (when you are awake) or until the swelling goes down. Put a thin cloth between the ice and your skin.