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JAMA Patient Page
August 22/29, 2017

Groin Hernia Repair by Open Surgery

JAMA. 2017;318(8):764. doi:10.1001/jama.2017.9868

There are 2 surgical approaches to hernia repair: open surgery and laparoscopic surgery.

The approach to fixing a groin hernia depends on multiple factors, including previous surgery, size of the hernia, whether abdominal contents are stuck (incarcerated), and general health.

After a patient receives medication to relax him or her and prevent pain, an open hernia repair is carried out by a surgeon who makes a 2- to 4-in incision near the groin hernia and identifying the abdominal contents that protrude through the weak area of the abdomen. These contents are contained in a structure called the hernia sac. The hernia sac is separated from important structures such as the spermatic cord and then returned back into the abdomen through the groin hernia. The hernia defect is repaired by bringing the groin tissues back together. In most circumstances, a prosthetic (man-made) mesh is placed over the hernia defect to decrease the chance that the hernia recurs. The incision is closed with small staples that are later removed or with stitches (sutures) that dissolve on their own over time. The wound is then covered with a dressing.

Most patients undergoing an elective or nonemergent groin hernia repair will go home the same day as the surgery once their pain is controlled, they have urinated, and they are able to tolerate food or liquids without nausea or vomiting.

Postsurgery Care at Home

Most patients can expect soreness over the first 1 to 2 days after surgery. Take pain medication as prescribed by your surgeon. Some patients may experience bruising (ecchymosis) in and around the groin area. This is normal. However, if there is significant swelling in the groin, you should contact your surgeon. You should walk every day but limit strenuous activity such as running and lifting anything over 5 to 10 lb (the equivalent of a gallon of milk) until evaluated by your surgeon at your postoperative visit 1 to 2 weeks after surgery. In general, if an activity hurts, it shouldn’t be done. Constipation and straining during bowel movements increases pressure on the repair and should be avoided; eat a high-fiber diet and use stool softeners if needed.

Contact your surgeon if you experience fever higher than 100.4°F, shaking chills, pain that gets worse over time, inability to urinate, inability to eat without feeling nauseous, or redness or pus draining from the incision(s).

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Article Information

Conflict of Interest Disclosures: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

Source: Beadles CA, Meagher AD, Charles AG. Trends in emergent hernia repair in the United States. JAMA Surg. 2015;150(3):194-200.

Topic: Hernia