Herniorrhaphy

Herniorrhaphy, or hernia repair surgery, is often the best approach to treat symptomatic hernias and prevent complications like incarceration and strangulation. This procedure can be performed in various approaches: open (traditional) and laparoscopically (minimally invasive).

What Is Herniorrhaphy?

Herniorrhaphy is a surgical procedure aimed at repairing a hernia. The surgery typically involves pushing the displaced tissue back into place and strengthening the area, often by stitching the muscle edges together.

When Is Herniorrhaphy Needed?

Herniorrhaphy is typically recommended when a hernia causes bothersome symptoms or risks complications. You might notice a bulge in your abdomen or groin that hurts, especially when you cough, lift something heavy, or stand for long periods. Emergency hernia surgery is generally recommended if the hernia causes sudden and severe pain or tenderness. This can be a critical sign that the hernia sac is either stuck (incarcerated) or has lost its blood supply (strangulated). Such situations are life-threatening emergencies that require immediate surgical intervention. Other signs indicating the need for emergency hernia surgery include:

• A bulge that has suddenly become larger
• A bulge that no longer goes back inside the abdomen
• Fever
• Nausea or vomiting
• Bloating
• Redness at the hernia site

What Are the Available Types of Herniorrhaphy Surgeries?

The two primary methods are open herniorrhaphy and laparoscopic (keyhole) herniorrhaphy. Your doctor will choose the best approach based on the hernia’s size, location, and your overall health.

• Open Herniorrhaphy

A traditional approach involving a single incision over the hernia. The surgeon pushes the tissue back into place and stitches the muscle, sometimes adding mesh for support. Commonly used for larger or complex hernias, recovery usually takes 4–6 weeks due to the larger wound and longer healing time.

• Laparoscopic (Keyhole) Herniorrhaphy

A minimally invasive technique using three or four small incisions. A camera guides the surgeon to repair the hernia from inside the abdomen, often with mesh. Recovery is quicker (typically 1–2 weeks), with less post-operative pain, smaller scars, and a faster return to daily activities compared to open surgery.

• Robotic Herniorrhaphy

Similar to laparoscopic surgery but performed with robotic instruments for greater precision and control. Small incisions are made, and the surgeon operates using a 3D console. Ideal for complex or recurrent hernias, this method offers enhanced accuracy, minimal scarring, and a faster recovery with fewer post-surgery discomforts.

How to Prepare for Herniorrhaphy

Proper preparation helps ensure a smooth surgery and recovery:

• Undergo a preoperative assessment to confirm you are fit for surgery.
• Inform your surgeon about all medications and supplements; some may need to be paused or adjusted.
• Clean the surgical area with antiseptic soap starting 48 hours before surgery, if instructed.
• Avoid food or drink after midnight before the procedure, except for essential medications taken with a small sip of water.

What to Expect During Herniorrhaphy

Generally, the procedure follows these steps:

• Anaesthesia – The patient will receive general or local anaesthesia to ensure their comfort.
• Incisions – The surgeon makes either a single large cut for open surgery or several small cuts for laparoscopic surgery.
• Repair – The surgeon repositions the herniated tissue back into place and repairs the weakened surrounding tissue. They may suture healthy tissue together to create a strong barrier wall.
• Closure – Finally, the surgeon sutures the incisions back together and dresses the wounds.

The procedure typically lasts between 30 minutes to 2 hours, depending on the hernia type and surgical complexity. Most patients can return home the same day.

What to Expect After Herniorrhaphy

Knowing what to expect after herniorrhaphy can help you prepare for your recovery. Here are some things you should expect after the surgery:

Recovery Timeline and Postoperative Care

Most patients recover well within a few weeks. You can typically return to light activities within 1–2 weeks and resume normal routines in 4–6 weeks. Full recovery may take up to 12 weeks, especially after open or complex hernia repairs.

Postoperative Care Tips

Proper postoperative care is crucial to ensure a smooth recovery and minimise the risk of complications.

• Pain Management – Use prescribed or recommended pain relief as needed.
• Wound Care – Keep the surgical site clean and dry to prevent infection.
• Physical Activity – Avoid heavy lifting or strenuous activity until your surgeon clears you.
• Diet and Hydration – Maintain a balanced diet and stay hydrated to support healing.
• Follow-Up Appointments – Attend scheduled visits to monitor healing progress and address any concerns.

What Are the Risks and Complications of Herniorrhaphy?

Herniorrhaphy is generally safe, but like all surgeries, it carries some risks. These may vary depending on the surgical method and individual health factors:

• Pain and Discomfort – Postoperative pain at the surgical site is common and may last several days to weeks.
• Swelling and Bruising – Mild swelling and bruising around the incision are common and usually resolve over time.
• Seroma and Haematoma – Fluid or blood may collect under the skin, especially after larger hernia repairs. These often go away without treatment.
• Infection – Signs include redness, swelling, warmth, or discharge at the incision. Most infections are mild and treated with proper wound care or antibiotics.