Explore the treatment options

Hernias will not heal on their own. Surgery is required to repair a hernia.

A hernia will not repair itself — surgery is required to repair a hernia. In a hernia repair surgery, a mesh implant is often used to reinforce the weakened tissue of the abdominal wall and close the opening. There are multiple mesh options that can be used in repair surgeries. There are also multiple surgical approaches that can be used while implanting a mesh. Your health care provider will help you to decide which surgical and mesh option is right for you. Learn about the different options below.

Surgical options in hernia repair

Multiple surgical approaches can be used to repair your hernia,  including open, laparoscopic or robotic surgery. Choosing the right one for you depends on your surgeon’s preference, your hernia type, and your unique situation. Laparoscopic and robotic surgical repairs are minimally invasive, meaning only a small incision is required for a surgeon to be able to repair the hernia with instruments. An open surgery is the more traditional type of surgery in which a surgeon would make an incision at the site of the hernia.

An open repair is a traditional surgical method where an incision is made at the site of  the hernia. If the surgeon uses mesh, it is then often placed between layers of muscle.1  After repairing the hernia, the surgeon then sews the weakened area and closes the opening with stitches, staples, or surgical glue.2  Depending on your surgical history, for example if a previous surgery has caused scar tissue, doctors may opt for this more traditional approach. Open repair surgeries may require more time to recover and may present more risks and complications compared to minimally invasive surgeries.3

Laparoscopic repairs are a type of minimally invasive surgery and require only small ‘keyhole’ incisions. These repairs use a small camera and tubes with specialized minimally invasive instruments.4  The abdomen may be inflated with carbon dioxide or a balloon to create space for the surgeon to work. Once the contents of the hernia are back to their natural position, a mesh is typically placed on the inner side of the gap to reinforce the weakened area of the abdominal wall.5  Minimally invasive surgery usually uses smaller surgical incisions, so patients may experience a faster hospital discharge and recovery following a laparoscopic repair compared to an open surgery.5,6

Like laparoscopic repair, robotic hernia repair is a minimally invasive surgery requiring small ‘keyhole’ incisions. The surgeon uses surgical instruments, such as a camera, and controls the procedure from a specialized robotic console. Three-dimensional imaging from inside the body cavity is displayed to assist the surgeon in directing the surgical procedure. A mesh reinforcement patch is often implanted to provide support to the repair behind the abdominal wall.4,6,7 
Minimally invasive surgery usually uses smaller surgical incisions, so patients may experience a faster hospital discharge and recovery following a robotic repair compared to an open surgery.8

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What is surgical mesh?

Surgical mesh is a medical device that provides additional support to weakened or damaged tissue. It acts as a base for the tissue to grow into. Depending on your hernia, your doctor could suggest a variety of types of mesh.

Mesh options for hernia repair 

Historically, non-mesh surgical options, such as sewing the edges of existing healthy tissue together to cover the hernia, were used and may still be considered for smaller hernias.9 Plastic, or synthetic, mesh has been used in hernia repairs for many years. However, natural, absorbable mesh options are also available. Understand your options before talking to your doctor about surgery.10,11  Whether bioresorbable mesh, synthetic mesh, or biologic graft, be sure to discuss the different options with your doctor to determine which mesh would best fit your needs.

Bioresorbable Mesh

A bioresorbable (or absorbable) mesh is made of natural biomaterials that are not considered foreign material to the body and are designed to dissolve over time. The mesh material is intended to break down and be absorbed into the body, leaving new tissue growth to protect and support the site of the repair.11,12

Synthetic Mesh

A synthetic mesh implant is made from plastic (e.g., polypropelene or polyester) and is a permanent implant used to repair hernias. Synthetic meshes remain in the body to help provide long term reinforcement to the repair, and are considered a more traditional approach.11,12 Surgical mesh made of synthetic materials can be found in knitted mesh or non-knitted sheet forms.

What to expect after a hernia surgery?

References

  1. New, less-invasive techniques for hernia repair. New York Presbyterian. June 2019. https://www.nyp.org/patients-and-visitors/advances-consumers/issues/new-less-invasive-techniques-for-hernia-repair
  2. Inguinal hernia – Diagnosis and Treatment. Mayo Clinic. April 24, 2021. https://www.mayoclinic.org/diseases-conditions/inguinal-hernia/diagnosis-treatment/drc-20351553
  3. Minimally Invasive Surgery. Mayo Clinic. September 24, 2021. https://www.mayoclinic.org/tests-procedures/minimally-invasive-surgery/about/pac-20384771
  4. Minimally Invasive Surgery. Mayo Clinic. September 24, 2021. https://www.mayoclinic.org/tests-procedures/minimally-invasive-surgery/about/pac-20384771
  5. Laparoscopic Hernia Repair. MedStar Health. 
https://www.medstarhealth.org/services/laparoscopic-hernia-repair 
  6. Robotic Surgery for Hernia Repair. Cleveland Clinic. September 27, 2019. https://my.clevelandclinic.org/health/treatments/17968-robotic-surgery-for-hernia-repair
  7. Hernia Repair Through Keyhole Incisions How Robotic Surgery Works. MedStar Health. June 5, 2018. https://www.medstarhealth.org/blog/robotic-surgery-hernia-repair
  8. Healthwise Staff. Open Inguinal Hernia Repair (Herniorrhaphy, Hernioplasty). University of Michigan Health, April 30, 2022. https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.open-inguinal-hernia-repair-herniorrhaphy-hernioplasty.hw170381
  9. Healthwise Staff. Open Inguinal Hernia Repair (Herniorrhaphy, Hernioplasty). University of Michigan Health, April 30, 2022. https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.open-inguinal-hernia-repair-herniorrhaphy-hernioplasty.hw170381
  10. Pluta RM, Burke AE, Golub RM. Abdominal Hernia. JAMA. 2011;305(20):2130. https://jamanetwork.com/journals/jama/fullarticle/900171
  11. Mesh and No Mesh Hernia Repair. Medstar Health, May 26, 2021. https://www.medstarhealth.org/blog/hernia-mesh-and-no-mesh-repair#:~:text=Mesh-and-No-Mesh-Hernia-Repair-May-26-support-the-weakened-area-in-the-abdominal-wall
  12. Fitzgerald, Kumar. Biologic versus Synthetic Mesh Reinforcement: What are the Pros and Cons? US National Library of Medicine, National Institutes of Health. December 27, 2014. https://pubmed.ncbi.nlm.nih.gov/35044431/