Doctors doing surgery

What Is Herniorrhaphy?

April 26, 2020

Herniorrhaphy (also known as hernia tissue repair) is one of the most commonly performed surgeries in the world, both on adults and children. A lot of people are afraid of surgeries because it is generally believed that surgeries are dangerous procedures, where people can lose their lives. However, some minor surgeries, like hernia tissue repair can be completed within an hour, and you can even go home the same day after the surgery.

It will surprise you to know that more than 350,000 hernias are surgically repaired in the United States alone every year. In fact, research has shown that one out of every four men will develop a hernia at some point in their life, although not everyone who has hernia will eventually require surgery. If hernias are that common, then it is important for us to learn when it is necessary to go for hernia tissue repair surgery.

Herniorrhaphy: Why Do People Need Hernia Tissue Repair

Hernia tissue repair refers to the surgical repair of a hernia. A hernia occurs when a weak spot in the muscle wall of the abdomen (belly) allows an internal organ or tissue in your body to push through. But then, hernia tissue repair is only recommended when the hernia becomes symptomatic (especially inguinal hernia), incarcerated or strangulated.

Symptomatic Inguinal Hernia

An inguinal hernia occurs when a loop of the intestine or internal tissues bulge through the inguinal canal. The inguinal canal is an opening that passes from the abdomen to the groin through the abdominal (belly) wall muscles. Tissues that may bulge through the inguinal canal include the tissue lining the inside of the abdomen and fatty tissue from inside the abdomen.

Surgery is always recommended when inguinal hernia occurs in children. However, for adults, surgery is only recommended when the inguinal hernia becomes symptomatic (causes pain or discomforts that interfere with daily activities). In some cases, hernias may never cause enough symptoms to require surgery.

Incarcerated Hernia

A hernia is said to be incarcerated when the herniated organ or tissue (the part of the intestine or abdominal tissue that passes through a weak spot in the abdominal wall) becomes trapped in the hernia sac. The hernia sac is the soft tissue that usually surrounds the herniated tissue or organ.

When a hernia is incarcerated, it becomes difficult for stool to pass through the intestine. This may cause symptoms such as pain, nausea, vomiting, and distension (swelling of the abdomen).

Strangulated Hernia

This happens very rarely, but if ever it happens, it can lead to serious complications. A strangulated hernia occurs when the trapped loop of intestine swells to the point that it becomes tightly trapped in the hernia sac. This can cause severe pain and distension.

In more serious cases, there may be severe bleeding, and the strangulated tissue may die and begin to decay (gangrene). Gangrene can further cause serious bacterial infection of the blood (septicemia), a life-threatening condition. Immediate tissue repair surgery is always required for a strangulated hernia.

How Safe is Herniorrhaphy?

There is no surgery that has no risks associated with it. Generally, there are two categories of risks associated with surgeries – Surgical complications (risks during the surgery) and post-surgical complications (risks after the surgery). However, herniorrhaphy is considered to be very safe and effective. Complications occur in only 3.6 percent of hernia tissue repair surgeries.

The main surgical risk for adults and children who undergo hernia tissue repair is a reaction to anesthesia. Actually, this is a common risk for all surgical procedures.

Although very rare and uncommon, some other complications that may occur during hernia tissue repair include:

  • Nerve damage during the surgery
  • Damage to the blood vessels that supply to scrotum or testicles resulting in atrophy of the testicles
  • In men, the vas deferens (the cord that carries sperm from the testicles to the penis) may be damaged. This results in sterility (an inability to father children).
  • Damage to the femoral artery or vein (the main blood supply to the thigh and leg).

After the surgery, it is quite common that there will be inflammation at the incision site (the place where the surgeon cut the belly will be painful, and it will appear swollen and red). Over-the-counter anti-inflammatory and pain-relief drugs may help treat inflammation and its associated symptoms.

Other complications that may occur after hernia tissue repair are less common. They include the following:

  • Infection of the surgery wound
  • Recurrence of the hernia
  • Development of a fluid-filled sac under the surface of the skin (Seroma)
  • Constipation (slow movement of the bowel)
  • Incontinence (leakage of urine)
  • Inability to urinate or difficulty in urinating
  • Internal bleeding (Hemorrhage)
  • Pooling of blood at the site of incision (Hematoma)
  • Adhesions (Excessive inner scars that cause internal tissues to stick together)
  • Urinary tract infection

When the surgery is performed by experienced surgeons, they know what to do to prevent these things from happening. And even if they do happen, a lot of them can still be corrected.

How Well Do People Recover after Herniorrhaphy?

Tissue repair of a hernia is usually carried out as an outpatient surgery for both adults (of all ages) and healthy children. This means it usually takes about 1 hour, and the patients are able to go home the same day. Before being discharged from the hospital after the surgery, the surgeon will explain to the patent what activities should be avoided and for how long.

It usually takes about 3 to 6 weeks to fully recover after you’ve had a hernia tissue repair surgery. After 1 to 2 weeks though, you should be able to go back to your normal daily activities and work, but without any form of strenuous exercise. You see, the time of recovery after hernia tissue repair is fairly short.

After 3 weeks, you should have almost fully recovered, and there should no longer be a pain, but it is usually advised at this time to only engage in light activities (like driving). Strenuous activities such as bicycle riding, swimming, and tree climbing should wait until after about 6 weeks.

Meanwhile, the chance that a hernia will happen again after it has been repaired surgically is very low. When the surgery is done in specialized centers by experienced surgeons, the hernia only comes back in only about 1% of the people.

When someone has a hernia that is symptomatic, incarcerated or strangulated, the herniated organ or tissue has to be put back into its proper place, so that it doesn’t become life-threatening. Also, the opening or weakness in the muscles of the belly wall that permitted the hernia to form must be closed or repaired, so that the hernia does not come back. This is what herniorrhaphy is all about.