Frequently Asked Questions

While the recurrence risk of hernia repair is generally low, some patients unfortunately experience a hernia recurrence. This can occur regardless of whether the initial repair was performed through the “open,” laparoscopic, or robotic technique, and it may manifest shortly after the repair or even a decade or two later. If a recurrent hernia causes any discomfort, pain, or concerns about its appearance or sensation, undergoing another operation is a viable option. Our surgeons are available to thoroughly discuss the available options with you. 

Regardless of the initial repair method, whether open, laparoscopic, or robotic, all three approaches can be considered for a recurrent hernia. While the procedure may pose some technical challenges for the surgeon, there is a high likelihood of a successful repair the second time around. The surgeons at DeKalb Surgical bring extensive expertise to hernia repairs, boasting a combined total of over 60 years of surgical experience! 

Some hernias are obvious, and some hernias are not. The more obvious ones can be diagnosed with some very simple education that is available at this website and elsewhere online. The obvious hernias are the ones where there is a visible bulge in your groin or at your belly button, that gets bigger when you cough or strain, and goes away when you lie down. There are not many things that would mimic that. 

Other hernias are not visible, or not as obvious. We see lots of patients who have groin pain and either think they have or might have even been told that they have a hernia, simply because they have pain in the appropriate place. But there are other conditions that can cause pain in this area. If you have some pain, but no visible bulge, you may or may not have a hernia. Surgeons who are experienced with hernias can determine what the correct diagnosis is.

Many patients initially diagnosed with a hernia become aware of it because of some pain related to it. Sometimes the pain can be quite severe, other times just some mild aching. Other patients have no pain at all, but simply notice a new bulge. If you are having no pain, or minimal pain from your hernia, it’s probably OK to continue your regular activities, including working and heavy lifting. However, common sense says that if you are having pain, you should avoid those activities until you get the hernia repaired. 

If you know you have a hernia, which has not yet been repaired, it’s important to pay attention to any related symptoms, specifically pain, but also whether the hernia remains soft, and whether it can be “reduced” by pushing on it. If your pain is continuous, and the hernia feels firm and tender and cannot be “reduced”, it might have become incarcerated, and you should seek medical attention immediately.

Although some families might be slightly more prone to develop hernias, for the most part they are “acquired,” related to factors such as obesity and the amount of strenuous activities that you do. 

It is possible to develop another hernia in the exact same area where a hernia was repaired as an infant. Also, you might have had a hernia develop in one groin, then develop another hernia on the other side in adult life, or add your belly button. 

Most hernias are repaired in the outpatient setting these days. There are exceptions, in particular, patients who have large hernias of the abdominal wall, in particular, hernias that might have developed along an incision for previous abdominal surgery. In some cases, the hernia repair might require an hours long procedure, with a lot of dissection. These patients might need to stay in the hospital for a few days. 

Surgery for the usual groin (inguinal) or umbilical hernias is virtually always done as in outpatient.

If it is your primary care physician who has diagnosed the hernia, it would be appropriate to ask how certain they are of the diagnosis. If your primary care physician is referring you to a surgeon, ask more about the surgeon you will be seeing, how much experience they have, And how many patients the doctor has sent to them for this condition in the past. 

Questions to ask of the surgeon would include, what technique do they recommend for repairing the hernia, how much experience they have with hernia repair, and what type of anesthesia will be used, whether it be “general”, or just sedation with local anesthesia. If you have any concerns about the use of mesh be sure to ask about this. 

Depending on your insurance coverage, you may be required to go to the surgeon recommended by your primary care physician. However, in most cases, you can do your own research and choose for yourself the surgeon you would like to see. 

Yes, there are other conditions that could be mistaken for a hernia. Everyone has lymph nodes in the groin area, near where hernias develop, and they can become enlarged and tender, and mimic a hernia. We also see many patients referred for possible hernia because they have groin pain, which may simply be a muscular strain in the area. There can also be other sorts of growths that can be felt, such as small fatty tumors called lipomas, cysts of the skin, and a variety of other less common things. 

Virtually all patients will experience some pain for the first few days following the surgery, and in most cases this has gone away between 1–3 weeks afterward. But there can be lingering pain related to the surgery, and there are some reports from different published reviews stating that this might be the case in as many as 20% of patients. Rarely would it be a pain that prevents one from doing all of their regular activities, though on occasion we do see this. 

A hernia truss is a type of belt that resembles a jockey strap, with a firm plate that might be made of metal or leather, which presses directly against the area where the hernia bulges out. They are available in pharmacies without a prescription. They may provide some benefit for some patients if it successfully prevents the hernia from bulging out. However, they do not always work as intended, and in fact on occasion, it seems the truss might actually make things worse. Sometimes the hernia will bulge out despite wearing the truss, and then the pressure of the truss might increase swelling of the hernia, actually causing it to become incarcerated. For this reason, most surgeons discourage using a truss. 

Most patients can resume all of their daily activities following a hernia repair, including heavy exercise and weight lifting. However, some patients may be at higher risk for having a hernia come back. This is most often the case for someone who has a hernia along a former surgical incision, or patients who are extremely overweight. And there are some patients who have unfortunately had more than one repair of a hernia, only to have it recur over and over. Such patients are advised to refrain from strenuous activity and weight lifting for obvious reasons. You should ask your surgeon what their recommendations will be regarding exercise and weight lifting following your surgery, and if they feel you are at increased risk for recurrence. 

There is a common misconception about what hernia surgery involves. In essence the hernia is a weak spot that allows the inner abdominal cavity to bulge out like a finger on a glove. Surgery for a hernia involves repairing the weak spot. The tissue that is bulging out from the abdominal cavity can be intestines, or fatty tissue. Sometimes there is fatty tissue stuck inside the hernia, and it might be easier to remove it than to push it back inside. So this might be removed. But the actual hernia surgery involves fixing the weak spot. The “contents” of the hernia sac would be pushed back into the abdominal cavity at the time of the repair. 

Yes, most hernia can be repaired without the use of mesh. However, mesh is a valuable resource for hernia repairs, as a strengthening reinforcement of the weak area. Mesh is probably used in about 95% of hernia repairs these days, and the benefits of using it far outweigh any tiny risks. The reinforcement from the mesh makes for a more durable repair, with a lower risk for recurrence. However, if you are convinced that you want a mesh free hernia repair, there are options available for most hernias. Your surgeon is likely to advise you that your risk of having a hernia come back will be higher if mesh is not used. Some patients may be OK with that if they are adamant about not having any mesh.

There are occasional cases in which a surgeon may recommend AGAINST repairing a hernia.  This may either be because of underlying medical conditions that would impact the risk for a complication related either to the repair or to the anesthesia required for the surgery.  Or there may be factors that raise the likelihood that a repair will ultimately fail, that is, recur.  If your surgeon estimates that your hernia is more likely to recur than not, it probably does not make sense to proceed in most cases. In our experience, the most common such situations would include patients with severe lung disease, or heart failure, or with morbid obesity, or a patient with a very complex hernia that may have already been unsuccessfully repaired before.