Medically reviewed by James Thomas Griscom, III, M.D. • The Surgical Clinic
Hernias are very common and can affect all ages. Once a hernia develops, it remains an anatomic defect that only surgery will fix. It can either remain the same or enlarge over time.
This expert guide by The Surgical Clinic in Middle Tennessee explains everything you need to know about hernia repair surgery, including when it may be time to see a surgeon for hernia repair, types of hernia surgery, and what you can expect in terms of recovery.
What Is a Hernia and How Does It Develop?
A hernia is a hole or weakness in the abdominal wall that allows an internal organ or tissue to push through the muscle or connective tissue that normally holds it in place.
Several types of hernias can occur depending on where the weakness develops, including inguinal hernias in the groin, umbilical hernias near the belly button, and ventral or incisional hernias in the abdominal wall.
Hernias can form over time or be present at birth. They typically develop when pressure within the abdomen pushes against a weakened area of the abdominal wall.
Common factors that may contribute to hernia development include:
- Heavy lifting or repeated physical strain
- Chronic coughing or sneezing
- Constipation and straining during bowel movements
- Pregnancy
- Previous abdominal surgery
- Aging or natural weakening of muscle tissue
Hernias are generally not dangerous, but they can become life-threatening if left untreated. The primary risk is a strangulated hernia, where tissue becomes trapped and loses blood supply, requiring immediate emergency surgery.
Types of Hernias That May Require Surgical Repair
A hernia may need surgical repair if the protrusion causes significant pain, increases in size, becomes trapped (incarcerated), or is needed to prevent serious complications like strangulation.
Common hernia types that often require surgery include:
- Inguinal Hernia
- Umbilical Hernia
- Ventral Hernia
- Incisional Hernia
- Hiatal Hernia
A surgeon will determine whether hernia repair surgery may be appropriate based on the type of hernia, symptoms, and your overall health.
When Does a Hernia Need Surgery?
If you have a hernia that remains stable, you may be able to delay surgery, but because hernias can’t heal on their own, most people eventually need hernia repair surgery.
Hernia surgery may be considered if it:
- Causes pain or persistent discomfort
- Interferes with normal daily activities
- Continues to enlarge over time
- Becomes trapped (incarcerated hernia) and loses blood supply (strangulated hernia).
A strangulated hernia is considered a medical emergency. Otherwise, hernia repair surgery is not always required immediately.
For smaller hernias that are not causing symptoms, a surgeon may recommend monitoring and watching for changes in symptoms or size.
If you have a hernia, a consultation with a surgeon can help determine whether monitoring or hernia repair surgery is the most appropriate next step.
Types of Hernia Repair Surgery
Modern hernia surgery generally uses three main approaches: open hernia repair, laparoscopic hernia repair, and robotic hernia repair. The most appropriate method depends on the type of hernia, its size and location, and the patient’s overall health.
Open Hernia Repair Surgery
Open repair remains a common approach, particularly for larger or more complex hernias.
In open hernia repair surgery, a surgeon makes an incision near the hernia site to access the weakened area of the abdominal wall. The protruding tissue is returned to its normal position, and the muscle defect is closed with sutures. In many cases, surgical hernia mesh may be used to strengthen the repair.
Laparoscopic Hernia Repair Surgery
Laparoscopic hernia repair surgery is a minimally invasive technique performed through several small incisions. A laparoscope, a thin camera, and specialized instruments allow the surgeon to repair the hernia without a large incision.
Because the incisions are smaller, this approach may reduce tissue disruption compared with traditional open surgery, although it is not appropriate for every hernia.
Robotic Hernia Repair Surgery
Robotic hernia repair surgery is a minimally invasive technique performed through small incisions using robotic-assisted instruments controlled by the surgeon.
The robotic system provides enhanced visualization and precision, which is helpful for certain abdominal wall repairs.
What Is the Difference Between Mesh and Non-Mesh Hernia Repair?
During hernia repair surgery, the hole in the connective tissue can be closed with sutures alone or reinforced with surgical hernia mesh, a medical device that strengthens the repaired area of the abdominal wall as surrounding tissue heals.
Mesh is commonly used in abdominal wall repairs because it provides additional support and helps reinforce the repair as tissue grows into the mesh. In some situations, a surgeon may perform a non-mesh hernia repair that relies solely on sutures to close the muscle defect. The decision to use mesh or sutures depends on factors such as the type of hernia, the size and location of the defect, and your overall health.
Is Hernia Repair Considered Major Surgery?
Hernia repair surgery may be considered major or minor depending on the hernia’s size and complexity, and the surgical technique used.
For many patients, hernia repair is not considered major surgery. Minimally invasive procedures, such as laparoscopic hernia repair, use small incisions and are often performed on an outpatient basis, allowing patients to return home the same day.
However, larger or more complex hernias may require open hernia surgery, which involves a larger incision to repair the hole in the connective tissue and may require additional monitoring or a short hospital stay.
How Long Does Hernia Repair Surgery Take?
The duration of hernia repair surgery varies depending on the type of surgery and the complexity of the hernia, but most repairs are completed in about 1 to 2 hours.
If only a simple repair is required, hernia surgery can take as little as 30 minutes. However, more complex repairs could require an operation that lasts as long as five hours.
Preparation time, anesthesia, and post-operative monitoring may add additional time at the surgical center.
How Long Is Recovery After Hernia Repair Surgery?
Recovery after hernia repair surgery varies depending on the type of hernia, the surgical method used, your overall health, and how closely you follow post-operative instructions.
For laparoscopic or minimally invasive hernia repair, many patients can resume light daily activities within a few days. For open hernia repair surgery, recovery may take longer because the procedure involves a larger incision and more tissue healing.
Most patients begin feeling better within a few days to a couple of weeks, but surgeons often recommend allowing about six weeks before returning to strenuous activity or heavy lifting so the abdominal wall can heal properly.
Hernia Surgery Recovery: What Patients Can Expect
First 24 to 48 Hours After Hernia Surgery
During the first day or two after hernia surgery, mild pain, swelling, or soreness around the surgical site is common. Patients are usually advised to rest, manage discomfort with medications recommended by their surgical team, and avoid strenuous activity. Light movement, such as short walks, may be encouraged to promote circulation and help reduce the risk of blood clots.
When Can You Return to Work After Hernia Repair Surgery?
The timing for returning to work depends on the type of work you do and the complexity of the repair. Those with desk-based or sedentary jobs may return sooner than people whose work involves heavy lifting or strenuous physical activity.
Your surgeon will provide guidance on when it is appropriate to resume work based on healing progress and the physical demands of your job.
When Can You Drive After Hernia Surgery?
Patients are usually advised to avoid driving until they can move comfortably without significant pain and are no longer taking medications that may impair reaction time or alertness. Your surgeon or care team will provide guidance on when it is appropriate to resume driving after hernia repair surgery.
Exercise and Lifting After Hernia Repair Surgery
Exercise and lifting should return gradually after hernia repair surgery. Light activity may be encouraged early in recovery, while heavier lifting and strenuous exercise are typically limited until the surgical site has healed.
Surgeons often provide specific lifting limits and timelines for resuming exercise. Following these guidelines helps support healing and reduce strain on the repair.
When to See a Surgeon for a Hernia
A consultation with a surgeon is recommended if a hernia begins causing symptoms, increases in size, or affects daily activities. You should consider seeing a surgeon if you have a hernia that:
- Causes ongoing pain or discomfort
- Appears to be increasing in size
- Interferes with normal daily activities
- Is associated with digestive symptoms such as nausea or difficulty swallowing in certain types of hernias
Certain symptoms may indicate a more urgent problem and require prompt medical attention. For example, a strangulated hernia occurs when blood flow to trapped tissue becomes restricted.
Warning signs that require immediate medical care may include:
- Severe or sudden pain near the hernia
- A bulge that becomes firm, tender, or cannot be pushed back in
- Nausea, vomiting, or abdominal swelling
- Redness or discoloration around the bulge
Hernia Repair Surgery in Middle Tennessee
At The Surgical Clinic in Middle Tennessee, our surgeons evaluate and treat a wide range of hernias. During a consultation, a surgeon will assess the type of hernia, review symptoms, and discuss possible treatment options based on your individual situation.
If you have noticed symptoms of a hernia or know you have a hernia and need hernia surgery, schedule a consultation with The Surgical Clinic for a professional evaluation and guidance on next steps.