What is Open Hernia Repair

Open hernia repair is a surgical procedure to fix a hernia. A hernia occurs when an internal organ or tissue pushes out through a weak spot in the abdominal wall muscles. Hernias commonly occur in the groin and around the navel.

Most hernias tend to get worse over time. Often, surgery is done to prevent the hernia from becoming bigger, uncomfortable, or an emergency. Emergency surgery may be needed if abdominal contents get stuck in the opening (incarcerated hernia) or the blood supply gets cut off (strangulated hernia). In an open repair, an incision is made in the abdomen to perform the surgery.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood or bone disorders you have.
• Any surgeries you have had.
• Any medical conditions you have, including any recent cold or flu symptoms.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Long-lasting (chronic) pain.
• Bleeding.
• Infection.
• Damage to the testicle. This can cause shrinking or swelling.
• Damage to the bladder, blood vessels, intestine, or nerves near the hernia.
• Trouble passing urine.
• Allergic reactions to medicines.
• Return of the hernia.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Medicines

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• You may be given antibiotic medicine to help prevent infection.

General instructions

• You may have blood tests or imaging studies.
• Ask your health care provider how your surgical site will be marked or identified.
• If you smoke, do not smoke for at least 2 weeks before your procedure or for as long as told by your health care provider.
• Let your health care provider know if you develop a cold or any infection before your surgery.
• Plan to have someone take you home from the hospital or clinic.
• If you will be going home right after the procedure, plan to have someone with you for 24 hours.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
  • Hair may be removed from the surgical area.
• An IV tube will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
• Your surgeon will make an incision over the hernia.
• The tissues of the hernia will be moved back into place.
• The edges of the hernia may be stitched together.
• The opening in the abdominal muscles will be closed with stitches (sutures). Or, your surgeon will place a mesh patch made of manmade (synthetic) material over the opening.
• The incision will be closed.
• A bandage (dressing) may be placed over the incision.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• You may be given medicine for pain.
• Do not drive for 24 hours if you received a sedative.

Care After Open Hernia Repair

These instructions give you information about caring for yourself after your procedure. Your doctor may also give you more specific instructions. If you have problems or questions, contact your doctor.

Follow these instructions at home:

Surgical cut (incision) care

• Follow instructions from your doctor about how to take care of your surgical cut area. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If you cannot use soap and water, use hand sanitizer.
  • Change your bandage as told by your doctor.
  • Leave stitches (sutures), skin glue, or skin tape (adhesive) strips in place. They may need to stay in place for 2 weeks or longer. If tape strips get loose and curl up, you may trim the loose edges. Do not remove tape strips completely unless your doctor says it is okay.
• Check your surgical cut every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Activity

• Do not drive or use heavy machinery while taking prescription pain medicine. Do not drive until your doctor says it is okay.
• Until your doctor says it is okay:
  • Do not lift anything that is heavier than 10 lb (4.5 kg).
  • Do not play contact sports.
• Return to your normal activities as told by your doctor. Ask your doctor what activities are safe.

General instructions

• To prevent or treat having a hard time pooping (constipation) while you are taking prescription pain medicine, your doctor may recommend that you:
  • Drink enough fluid to keep your pee (urine) clear or pale yellow.
  • Take over-the-counter or prescription medicines.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried and sweet foods.
• Take over-the-counter and prescription medicines only as told by your doctor.
• Do not take baths, swim, or use a hot tub until your doctor says it is okay.
• Keep all follow-up visits as told by your doctor. This is important.

Contact a doctor if:

• You develop a rash.
• You have more redness, swelling, or pain around your surgical cut.
• You have more fluid or blood coming from your surgical cut.
• Your surgical cut feels warm to the touch.
• You have pus or a bad smell coming from your surgical cut.
• You have a fever or chills.
• You have blood in your poop (stool).
• You have not pooped in 2–3 days.
• Medicine does not help your pain.

Get help right away if:

• You have chest pain or you are short of breath.
• You feel light-headed.
• You feel weak and dizzy (feel faint).
• You have very bad pain.
• You throw up (vomit) and your pain is worse.