Location Map FAQ
St. Maarten Medical Center
A hernia is a bulge through an opening in the muscles on the abdomen. If the hernia reduces in size when a person is lying flat or in response to manual pressure, it is reducible. If it cannot be reduced, it is irreducible or incarcerated, and a portion of the intestine may be bulging through the hernia sac. A hernia is strangulated if the intestine is trapped in the hernia pouch and the blood supply to the intestine is decreased. This is a surgical emergency. An epigastric hernia bulges midline above the umbilicus.
The most common symptoms of a hernia are:
Sharp abdominal pain and vomiting may mean that the intestine has slipped through the hernia sac and
is strangulated. This is a surgical emergency and immediate treatment is needed.
Open hernia repair—An incision is made near the site, and the hernia is repaired with mesh or by
suturing (sewing) the muscle closed.
Laparoscopic hernia repair—The hernia is repaired by mesh or sutures inserted through instruments
placed into small incisions in the abdomen.
Watchful waiting is an option for adults with hernias that are reducible and not uncomfortable.
The type of operation depends on the hernia size, location, and if it is a repeat hernia. Your health,
age, anesthesia risk, and the surgeon’s expertise are also important. An operation is the only treatment
for a hernia repair.
The surgeon makes an incision near the hernia site. The bulging tissue is gently pushed back into
the abdomen. Sutures, mesh, or a tissue flap is used to close the muscle. With complex or large
hernias, small drains may be placed going from inside to the outside of the abdomen. The site is
closed using sutures, staples, or surgical glue.
The hernia sac is removed. Mesh is placed over the hernia site. The mesh is attached using sutures sewn
into the stronger tissue surrounding the hernia site. Mesh is often used for large hernia repairs and
may reduce the risk that the hernia will come back. The site is closed using sutures, staples, or
The surgeon will make several small punctures or incisions in the abdomen. Ports or trocars
(hollow tubes) are inserted into the openings. Surgical tools are placed into the ports. The
abdomen is inflated with carbon dioxide gas to make it easier for the surgeon to see the hernia.
Mesh is sutured, stapled, or clipped to the muscle around the hernia site. The hernia site can
also be sewn directly together.
Watchful waiting is an option for a hernia without symptoms. All patients should get treatment if they have sudden sharp abdominal pain and vomiting. These symptoms can indicate an incarcerated hernia and bowel obstruction.
Trusses or belts made to apply pressure on a hernia require correct fitting.
You will be moved to a recovery room where your heart rate, breathing rate, oxygen saturation, blood pressure, and urine output will be closely watched. Be sure that all visitors wash their hands.
Movement and deep breathing after your operation can help prevent postoperative complications such as blood clots, fluid in your lungs, and pneumonia. Every hour, take 5 to 10 deep breaths and hold each breath for 3 to 5 seconds.
When you have an operation, you are at risk of getting blood clots because of not moving during anesthesia. The longer and more complicated your surgery, the greater the risk. This risk is decreased by getting up and walking 5 to 6 times per day, wearing special support stockings or compression boots on your legs, and for high-risk patients, taking a medication that thins your blood.
If general anesthesia is given or if you need to take narcotics for pain, it may cause you to feel different for 2 or 3 days, have difficulty with memory, or feel more fatigued. You should not drive, drink alcohol, or make any big decisions for at least 2 days.
Avoid straining with bowel movements by increasing the fiber in your diet with highfiber foods or over-the-counter medicines (like Metamucil® and FiberCon®). Be sure you are drinking 8 to 10 glasses of water each day.
The amount of pain is different for each person. The new medicine you will need after your operation is for pain control, and your doctor will advise how much you should take. You can use throat lozenges if you have sore throat pain from the tube placed in your throat during your anesthesia.
Contact your surgeon if you have: