The only treatment option for many types of hernia is surgery, and some types of hernia, referred to as 'non reducible', need urgent surgery.
Depending on the type of hernia, surgery can either be conventional 'open' surgery or laparoscopic (also known as 'keyhole' or 'minimally invasive') surgery. One of two techniques are used to repair a hernia - either a 'tension suture' where the breached muscle wall is repaired by sewing the two split components back together, or a 'surgical mesh' where a section of medical grade plastic mesh is fixed into the gap in the muscle wall.
The following surgical approaches are employed:
Inguinal Hernia
Inguinal herniae can be repaired using either open or laparoscopic approaches, although in most cases the laparoscopic approach is preferred, using mesh to 'plug' the hernia. This procedure is carried out under a general anaesthetic, with three small incisions (all less than 1cm) needed. The patient can generally return home on the same day after a short period of observation. An inguinal hernia can also be repaired using open surgery, with one slightly larger incision made in the groin area. Recovery times are similar in both cases.
Hiatus Hernia
A hiatus hernia is generally repaired using laparoscopic surgery, with five small incisions made in the upper abdomen. A general anaesthetic is required. The procedure involves tightening the opening in the diaphragm muscle (the 'hiatus') and fixing of the stomach in a position to prevent reflux. After a procedure to repair a hiatus hernia a hospital stay of 1-3 days is generally required.
Umbilical Hernia
An umbilical hernia is normally repaired using open surgery. A curved incision is made underneath the navel and the hernia itself, which is generally a small section of abdominal fat, is removed. A piece of surgical mesh may be inserted if the hernia is larger than 1cm. Generally umbilical hernia repair is a quick procedure with the patient normally able to return home on the same day after a period of observation. You may receive a general anaesthetic, a regional anaesthetic (e.g. spinal, epidural) or a local anaesthetic during the procedure.
Femoral Hernia
A femoral hernia can be repaired using either open or laparoscopic surgery. The laparoscopic procedure requires three small incisions to the groin and lower abdominal areas, whereas the open technique involves one slightly larger incision in the groin area. Some of the hernia tissue may be removed before the remaining protruding tissue is pushed back into the abdominal cavity. The muscles are then sewn back together. Surgical mesh may also be used. This procedure is generally conducted under a general anaesthetic, but regional and local anaesthetic may also be an option.
Incisional/Ventral Hernia
This type of hernia can be repaired with either laparoscopic surgery or open surgery. The hernia is moved back inside the abdominal cavity and a section of surgical mesh is fixed into place. This procedure is usually performed under a general anaesthetic and most patients are able to return home the same day.
For more information on hernia see our section Herniae.