Hernia Surgery

What is a hernia?

A hernia happens when there is a weakening of the inside layers of the abdominal wall weaken, which then tear or bulge. The abdomen’s inner lining pushes through to form a balloon-like sac. A loop of the intestine or tissue can move into the sac, causing pain and other potentially serious health problems.

Hernias are usually caused by either a natural weakness in the abdominal wall or excessive strain on the abdominal wall (such as heavy lifting, persistent coughing, substantial weight gain, or difficulty going to the toilet). Most hernias are located near the groin. They can also occur below the groin (femoral), through the navel (umbilical), and along a previous incision (incisional).

Symptoms of hernias include:

• A dull aching sensation
• A noticeable bulge in the groin area or in the abdomen
• A vague feeling of fullness
• Feeling pain while lifting
• Nausea and constipation.

Treatment for a hernia

A hernia won’t go away on its own, so surgery is the only way to repair it. There are two main types of surgery for a hernia:

• Open: A cut is made so the surgeon can push the protrusion back into the abdomen.
• Laparoscopic: A minimally invasive surgery performed with smaller incisions and using special instruments to repair the hernia.

Each type of surgery has advantages and disadvantages, and your surgeon will review your case carefully and select the most appropriate surgical technique.

Surgical options for a hernia include:

Laparoscopic surgical hernia repair

Also called keyhole surgery, this is a minimally invasive surgery that can be used to repair many types of hernia. The surgeon will make three or four very small incisions (one to two centimeters long). An instrument called a laparoscope, which has a light and a camera, is inserted allowing the surgeon to see inside the abdomen. Special surgical instruments are then inserted through the incisions which allow the surgeon to put the hernia back into its correct place.

There are two types of laparoscopic hernia surgery:

• Totally extraperitoneal (TEP): A technique that involves repairing the hernia without entering the abdominal cavity.
• Transabdominal preperitoneal (TAPP): Surgical instruments are inserted through the muscle wall of the abdomen and enter the abdominal cavity through the lining that covers the organs. This lining is called the peritoneum, and a flap of it is peeled over the hernia and the weakened area is strengthened with a piece of mesh.

Laparoscopic surgery is associated with less pain after the procedure and a faster healing time (due to smaller incisions).

Robotic hernia repairs

Robotic surgery is an advanced surgical technique for hernia repairs. Like laparoscopic surgery, a laparoscope is inserted through tiny incisions, but the surgeon controls the surgical instruments via a console. Robotic surgery offers 3D imaging of the inside of the body and allows for greater dexterity and precision.

Robotic surgery offers less pain and faster recovery than traditional open surgery and allows the surgeon a greater degree of accuracy.

Open surgical hernia repair

Traditional open surgery involves the surgeon making one long incision (three to six inches long) so they can access the hernia. Although the technique is more invasive and associated with a longer recovery and sometimes a longer stay in hospital, it is often the best option for some patients.

Complex abdominal wall reconstruction

This type of surgery is needed to repair damage and defects acquired from previously failed surgeries or to treat recurrent hernias. This type of surgery can be performed using open, laparoscopic, or robotic techniques.

The aim is to repair the damaged area, place the hernia back into its correct position and strengthen the weakened abdominal wall with mesh or stitching. Abdominal tissue is reshaped by separating the layers of the abdominal wall and strengthening each with a layer of mesh to support the abdominal muscles.

Which type of surgery is right for me?

Each type of surgery has its advantages and disadvantages. Surgeons from our Hernia Repair Program take a tailored approach to ensure the best possible outcome. They assess each patient and their individual care to select the most appropriate surgical technique.

Our Hernia Surgery Program is comprised of experienced surgeons specialized in advanced laparoscopic and robotic procedures, as well as traditional open surgery and complex reconstructive surgery, for the treatment of abdominal wall and hernia conditions.

Learn more.