Expert surgical solutions for complex hernia problems
At Penn Medicine, you have access to some of the nation’s top experts in hernia repair surgery. We use advanced robotic and minimally invasive techniques, so you feel better faster.
Our team has unique expertise in managing the most complicated hernias and has helped patients regain quality of life and return to the daily activities they love the most—without pain or discomfort. Penn hernia surgeons – general, gastrointestinal, and plastic surgeons – have received regional and national acclaim for their skill and expertise. We deliver excellent outcomes with a low rate of complications, such as recurrence (hernia that comes back after surgery).
Are you a candidate for hernia surgery?
Many people who have a hernia do not require surgery. Small hernias may cause no symptoms. Even most people with larger hernias that lead to related health concerns, like hiatal hernias that lead to gastroesophageal reflux disease (GERD), get sufficient symptom relief from medication or lifestyle changes.
Surgery is often recommended for large hernias that cause serious symptoms that are not controlled with medication. Occasionally these hernias can become emergency operations if they cause an urgent side effect, such as an obstruction or ischemia (lack of blood flow). Surgery also benefits people who can't tolerate or prefer not to take medication long-term.
Generally, candidates for hernia repair surgery include individuals who:
- Experience significant pain or discomfort: This can include pain during physical activity, persistent aching, or sharp pain.
- Have a growing hernia: Hernias that are increasing in size may require surgical intervention.
- Have an incarcerated hernia: This occurs when the hernia cannot be pushed back.
- Have a strangulated hernia: This is a medical emergency where the blood supply to the herniated tissue is cut off.
Doctors consider many factors before deciding whether (and which) surgery may be right for you.
Types of hernia surgery we perform
Our renowned hernia surgeons perform a high volume of sophisticated surgeries to repair common and rare types of hernias, including:
Umbilical hernia surgery repairs a hernia that happens close to the belly button.
Abdominal hernia surgery may be needed to repair a hernia that occurs elsewhere along the abdomen. You may develop this type of hernia after any previous abdominal surgery that can weaken abdominal tissues.
Incisional hernia surgery may be required after any prior operation you have had. Any incision that has a weakness around the muscle or tissues can develop a small bulge or hernia.
Parastomal hernia surgery repairs hernias or bulges that develop around a stoma or ostomy. These can cause an obstruction of the ostomy.
Spigelian hernia surgery is required for a rarer abdominal wall hernia that can occur on the left or right side of your abdomen.
Flank hernia surgery is most commonly needed after a prior surgery or accident on the left or right side of your abdomen that causes a bulge.
Complex abdominal wall reconstructive surgery may be needed for hernias that have been repaired multiple times and come back. Reconstructive surgery is also used when complications follow hernia repair.
Inguinal hernia surgery repairs a hernia that occurs in the groin area in the lower abdomen. Inguinal hernia mostly happens to men. Our team developed new ways of treating a rare complication that causes some people to experience severe, long-term groin pain after hernia repair surgery.
Femoral hernia surgery fixes a hernia that happens at the top of the thigh. Femoral hernias are less common and tend to affect older women.
Hiatal hernia surgery repairs hiatal or paraesopahgeal hernias in which the stomach pushes up into the chest through a widening of the muscles that separate the abdomen from the chest. This surgery can be similar to acid reflux surgery. It can be a long-term cure for certain cases of heartburn or acid reflux symptoms.
Internal hernia surgery repairs a twisting of the intestines that can happen after prior surgery. It most commonly occurs after weight loss surgery such as gastric bypass.
Diaphragmatic hernia surgery repairs a diaphragmatic hernia in the breathing muscles (the diaphragm) that allows tissue from the abdomen to move into the chest. These hernias are most often caused by accidents and other operations in the chest.
What happens during surgical hernia repair?
Hernia repair surgery can either be done through open repair or laparoscopic (minimally invasive) repair. Open repair uses traditional surgical incisions and is typically more invasive, whereas laparoscopic minimally invasive repair uses a few very small incisions. Minimally invasive and robotic surgery has a faster recovery time than open repair but is not appropriate for all conditions or patients.
Regardless of the approach used, during hernia surgery a surgeon:
- Puts you to sleep with general anesthesia.
- Makes one or more incisions near the affected area to reach the hernia.
- Pushes the bulging tissue back into place where it belongs using advanced instrumentation to assist.
- Repairs the weakened muscle and connective tissues by closing the hole (hernia defect) where the hernia has occurred with stitches.
- In many cases, reinforces abdominal muscles with mesh material to add extra support to prevent a hernia from developing in the future.
Some hernia patients also require soft tissue reconstruction, repair of other internal structures or the removal of excess skin. This may be needed to prevent infection or improve function and appearance. Penn gastrointestinal surgeons and plastic surgeons collaborate to provide the best results.
Hernia surgery recovery
Some hernias can be repaired with routine outpatient surgery, so you go home the same day. More complex hernias may require a more involved procedure that requires a short hospital stay. After hernia repair surgery, we monitor your healing and overall health for up to two years.
Before surgery, your care team will go over key points explaining what to expect during your recovery. We also offer advice for promoting your body’s healing process.
After surgery, our team will check in with you at various times to make sure you're recovering well. We’ll point you toward physical therapy, nutrition counseling or other specialty care that may help you heal or prevent another hernia. Our extensive hernia surgery recovery and rehabilitation encourage healthy habits to reduce your risk of having another hernia.
Coordinated approach to hernia repair at Penn Medicine
At Penn Medicine, multiple doctors with different areas of expertise work together to consider all perspectives and make the best possible decisions regarding your care. Depending on your needs, your care team may include general and gastrointestinal surgeons, plastic surgeons, pain management doctors, nurses, and physical therapists. This advanced level of coordination helps us provide expert hernia care.
Our physicians take what they do personally. We understand how much a hernia can affect your life. We want to give you the best results possible.
We take the time to listen to your concerns and we never rush you. We walk you through all your treatment options and answer any questions you have along the way.
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