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HealthInfo Canterbury

Hernia repair surgery

Not all hernias need to be treated. But when they do, it is with an operation called a hernia repair. This can be done by keyhole surgery (also called laparoscopic surgery) or by using a larger cut (open surgery).

In keyhole surgery the surgeon makes several small cuts in your abdomen. They insert surgical instruments, including a telescope and light, into your body through these small cuts to find and repair the hernia.

Sometimes the surgeon needs to change from keyhole surgery to open surgery during the operation. This will make a larger wound and you may need to stay longer in hospital.

The hernia is repaired by pulling together muscles and ligaments to close the opening, or by using a patch of mesh to hold your hernia in. Your surgeon will discuss which option is the best for you.

Most people are put to sleep under a general anaesthetic for hernia repair surgery, but some people have a local or regional anaesthetic instead. You may go home the same day, without staying overnight. However, if you have a larger hernia you may need a few days in hospital to recover from the surgery.

Before surgery

You may need to complete a health questionnaire or come to a pre-admission clinic, depending on your circumstances. Continue taking all your medicines until you're told to stop them. If you are taking blood-thinners (such as warfarin or dabigatran) make sure your surgeon knows this, and ask what you should do.

If you are planning to have surgery it is best to try to stop smoking. Smoking slows down healing and increases the risks of surgery. Also read about how you can best prepare for your operation.

Can I have my hernia repair through the public health system?

The public health system offers surgery for severe hernias in limited circumstances.

Many people have hernia repairs funded by ACC or done privately (often paid for by health insurance). ACC covers hernia repairs if your hernia was caused by a sudden workplace accident or injury. If this is the case, talk with your employer and also see your doctor as soon as possible, as you need to lodge an ACC claim within a few weeks.

ACC may also fund surgery if your hernia has developed around the scar from a previous surgery (this is called an incisional hernia).

The Canterbury Charity Hospital can also perform open hernia repairs. Talk to your doctor about what options you have.

You may want to pay a private general surgeon to perform your hernia repair.

What are the risks and complications of hernia repair surgery?

Most hernia repairs are low risk, but all operations carry some risk, and it's important to discuss this with your surgeon before you decide if you want surgery. Tell them about any problems you have had with operations or healing, including reactions to medicines. The risks below are not the only risks but are the most common ones, or the most serious.

Specific risks of hernia repair surgery

After surgery, some people get a fluid-filled area called a seroma, which may need draining. Seromas are common after larger hernia repairs. A few people (less than 10%) get chronic pain after an open inguinal repair, this is less common after keyhole repair. Very rarely, there is injury affecting the bladder or bowel.

Your hernia may also come back. This happens in around 1% of open inguinal hernia repairs, 0.2% of laparoscopic inguinal hernia repairs, and 10% of incisional hernia repairs.

General surgery risks

Your wound may become infected, and you may need antibiotics. Your wound may take a long time to heal, or may split apart while it is healing.

You may bleed excessively, and rarely you may develop a haematoma (collection of blood) that needs draining with another operation. You may have an allergy or reaction to the anaesthetic, which, rarely, can be life-threatening. You could develop a blood clot in your legs or lungs, a serious though uncommon complication.

On the next page: Mesh hernia repair

Written by HealthInfo clinical advisers. Endorsed by clinical director, Surgery, Canterbury DHB. Page created January 2015.

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Review key: HIHER-19885