For open hernia repair surgery, a single long incision is made in the groin. The hernia sac is either pushed back or tied off and removed.
The weak spot in the muscle wall—where the hernia bulges through—traditionally has been repaired by sewing the edges of healthy muscle tissue together (herniorrhaphy). This is appropriate for smaller hernias that have been present since birth (indirect hernias) and for healthy tissues, where it is possible to use stitches without adding stress on the tissue. But the surgical approach varies depending on the area of muscle wall to be repaired and the surgeon's preference.
Mesh patches of synthetic material are now being widely used to repair hernias (hernioplasty). This is especially true for large hernias and for hernias that reoccur. Patches are sewn over the weakened area in the belly wall after the hernia is pushed back into place or tied off and removed. The patch decreases the tension on the weakened belly wall. This reduces the risk that a hernia will come back.
Surgical repair is recommended for inguinal hernias that are causing pain or other symptoms and for hernias that are incarcerated or strangulated. Surgery is always recommended for inguinal hernias in children. Infants and children usually have open surgery to repair this type of hernia.
Open surgery for inguinal hernia repair is safe. The recurrence rate (hernias that require two or more repairs) is low when open hernia repair is done by experienced surgeons using mesh patches. Synthetic patches are now widely used for hernia repair in both open and laparoscopic surgery. The chance that a hernia needs more than one repair also depends on your age and overall health.
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