Hernia Repair

What a hernia is and its repair

A hernia is a condition in which part of the abdominal content, most often a piece of fatty tissue or a loop of intestine, protrudes through a weakened or widened spot in the muscular-connective wall of the abdomen. At that spot a soft bulge appears beneath the skin, which often enlarges with straining, coughing or long standing, and in the lying position sometimes partly or fully recedes.

The most common form is the inguinal hernia, which appears in the groin area and is more frequent in men. The umbilical hernia appears around the navel and occurs in both adults and children. There are also hernias at the site of earlier surgical incisions, so-called incisional hernias. What they have in common is that they form at a weakened part of the abdominal wall and cannot be cured with medication.

Hernia repair is a surgical procedure that returns the content of the hernia to the abdominal cavity and closes and reinforces the weakened spot. In most adult patients the abdominal wall is additionally strengthened by placing a synthetic mesh, which over time integrates with the tissue and considerably reduces the likelihood that the hernia will reappear. The goal of surgery is to remove the bulge, prevent complications and return the patient to a normal life without symptoms.

When hernia repair is indicated

A hernia is a condition that, as a rule, worsens over time, so surgery is in most cases the only lasting solution. In many patients an elective operation is recommended while the hernia is still small and there are no complications, because the procedure is then simpler and recovery easier.

There are also situations when surgery is urgent. If the hernia can no longer be returned to its place, if it becomes painful, hard and accompanied by nausea, it may be an incarceration, a condition in which the blood supply to the hernia content is compromised. An incarcerated hernia is an emergency that requires immediate surgical care.

• A visible bulge in the groin or around the navel that is enlarging
• A feeling of pressure, heaviness or pulling in the hernia area
• Pain or discomfort with straining, coughing, lifting or standing
• A bulge that does not recede even in the lying position
• A sudden, intensified and persistent pain in the hernia area
• A hard, tense hernia accompanied by nausea or vomiting
• A hernia that interferes with daily activities and work
• A hernia at the site of an earlier abdominal operation

How hernia repair is performed

Hernia repair is planned individually, according to the type and size of the hernia, the patient's general condition and the examination findings. The essence of every technique is the same: the hernia content is carefully returned to the abdominal cavity, and the weakened spot in the wall is closed and reinforced so the hernia does not return.

In the open technique the surgeon makes an incision over the hernia, dissects the hernia sac, returns the content and places a mesh that reinforces the abdominal wall. In the laparoscopic technique the procedure is performed through several small incisions with the help of a camera and special instruments, with the mesh placed on the inner side of the wall. The choice of technique depends on the specific case and is decided by the surgeon in agreement with the patient.

Mesh placement is today the standard in adult patients because it considerably reduces the possibility of the hernia reappearing. The mesh is made of a material the body tolerates well and over time integrates with the surrounding tissue, creating firm support at the site of the former weakness.

Preparation

Preparation for hernia repair begins with an examination and conversation with the surgeon, at which the diagnosis is confirmed and the most suitable technique is agreed. Before an elective operation, basic laboratory tests and an anesthesiologist's assessment are usually done, so the procedure is performed as safely as possible.

Good preparation also means that the doctor knows everything about your health and habits. It is especially important to state chronic illnesses and medications you take, because some of them require adjustment before surgery. Quitting smoking and regulating body weight before an elective procedure further contribute to easier recovery.

• Tell the doctor about all chronic illnesses, especially of the heart, lungs and diabetes
• State all medications, especially blood thinners
• Report allergies to medications, anesthetics and materials
• Follow the instructions on fasting before surgery under general anesthesia
• Arrange accompaniment and transport home after the procedure
• Prepare comfortable clothing that does not press on the operation area

The procedure, anesthesia and duration

The type of anesthesia depends on the technique and the anesthesiologist's assessment. Hernia repair can be performed under general anesthesia, under spinal anesthesia or, for smaller hernias, under local anesthesia with mild sedation. The most suitable form is decided before the procedure, taking into account your condition and wishes.

The operation itself most often takes between thirty minutes and an hour, depending on the type and size of the hernia and the chosen technique. During the procedure you feel no pain, and the team carefully monitors your condition the whole time. After the operation the wound is closed with sutures and dressed with a sterile bandage.

For smaller hernias the patient is often discharged the same day, while for more complex procedures a short stay is recommended for observation. Before going home you receive detailed instructions on wound care, permitted activities and follow-up appointments.

Recovery

Recovery after hernia repair is, for most patients, gradual and predictable. In the first days tenderness, tightness and slight swelling in the area of the incision are possible, which settles with rest and prescribed therapy. The wound is kept clean and dry, and the sutures are removed as agreed, usually within a few days to two weeks.

The return to daily activities is gradual. Lighter activities most often resume after a few days, while lifting and intense physical strain are postponed for several weeks, until the abdominal wall has fully recovered. You agree on a precise schedule of loading with the surgeon, because too fast a return to strain increases the risk of the hernia reappearing.

• In the first days rest and avoid straining the abdominal wall
• Keep the wound clean and dry and dress it according to the instructions
• Do not lift weights until the surgeon explicitly allows it
• Gradually increase activity, without sudden movements and strain
• Take care of regular bowel movements to avoid straining
• Report severe pain, redness, swelling or a raised temperature

Possible risks

Hernia repair is today a routine and safe procedure, but like any surgical intervention it carries certain risks. The great majority of them are rare and solvable, and an open conversation with the surgeon before surgery helps you understand the possible outcomes and recognize in time the signs that require contact.

Recurrence of the hernia in the same place is possible, but with modern techniques and mesh placement it is considerably rarer. Proper recovery and following the instructions on loading further reduce that risk.

• Bleeding or the formation of a bruise in the operation area
• Wound infection or, more rarely, a reaction to the placed mesh
• A collection of fluid or swelling in the procedure area
• Temporary numbness or a change of sensation around the incision
• Recurrence of the hernia in the same place
• Transient problems with urination or a feeling of tightness

Why Medical Time

At the Medical Time center in Belgrade we approach hernia repair individually, choosing the technique that best suits your condition and way of life. The entire journey, from examination and preparation to recovery, is led by an experienced surgical team with clear communication at every step.

• An experienced surgical team and modern operative techniques
• An individual assessment and choice of approach for each patient
• Placement of a quality mesh for a lower risk of recurrence
• Detailed preparation and cooperation with the anesthesiologist
• Clear recovery instructions and regular follow-ups

Price

The price of hernia repair is determined after an examination, because it depends on the type and size of the hernia, the chosen surgical technique, the type of anesthesia and the need for mesh placement. For this reason the final amount cannot be set in advance without an assessment of the condition.

To get a clear idea of the range of costs, look at our surgical services in the price list and book a consultation. At the examination you will receive a proposed operation plan and all the information needed for a decision.

• Examination and surgeon's assessment before the operation
• Inguinal or umbilical hernia repair
• Mesh placement to reinforce the abdominal wall
• Follow-up examinations during recovery

For an estimate and an appointment, call 062-399-888.

Frequently asked questions