Open hernia surgery is the standard of care in hernia repair. In open surgery, the skin and fat over a hernia are opened, the hernia is located, and a small mesh is placed under the hole in the muscle. The skin is then closed over the hernia repair site. Open surgery can be used for all hernias including inguinal, umbilical, incisional, ventral, sports, and femoral.
Open Hernia Surgery – Inguinal
Inguinal hernias are caused by a hole in the muscle of the groin. This hole can either be lateral to the blood vessels (indirect inguinal hernia), or towards the middle from the blood vessels (direct inguinal hernia). Regardless, in open surgery, the muscle layers over the weakened muscle are opened. The hole (or holes) in the muscle are found. A dual sided mesh is used to reinforce the hernia defect and the muscle around the hole.
The dual mesh allows one layer (with the blue circles) to be placed under the muscle, while the other top layer is placed over the damaged muscle. With this type of repair, the weakened muscles are treated from both the inside AND the outside of the hole. This cannot be done in laparoscopic surgery since only an inner layer mesh can be used.
Open Hernia Surgery Video – Inguinal
In the video below, Dr. Harris narrates an open inguinal hernia repair done at California Hernia Specialists’ hernia center.
Open Inguinal Hernia RepairDr. Harris narrates an actual open inguinal hernia repair done at our hernia center.
Open Hernia Surgery – Umbilical
Umbilical hernia repairs are almost always best done open. During open surgery, a small incision is made in the crease under the belly button. The belly button is lifted off of the underlying muscle and fat. The hole in the muscle is exposed and a mesh is placed through the hole.
The mesh is then sutures (sewn) to the surrounding healthy muscle in several locations. Once the mesh is securely fastened to the muscle, the belly button is replaced down to the muscle or fat and the skin is sewn closed.
Open Hernia Surgery Video – Umbilical
In the video below, Dr. Harris narrates an open umbilical hernia repair done at California Hernia Specialists’ hernia center.
Open Umbilical Hernia RepairDr. Harris narrates an actual open umbilical hernia repair done at our hernia center.
Tension Free Hernia Repair
The term ‘tension free’ hernia repair is commonly used to describe hernia surgery. Hernias are caused by a weakening of the abdominal muscles. Some surgeons choose to sew the muscles back together, thus causing ‘tension’ on the muscles around the hernia. However, the muscles around a hernia are already weak, and over time those muscles tend to pull apart and the hernia can recur, or come back.
Therefore, most hernia specialists today utilize a mesh to help strengthen the muscles. When using a mesh, the muscles themselves are not sewn together (see below). Instead, a mesh is placed over or under the hole in the muscle to prevent anything from pushing through the abdominal wall.
Some patients have heard or read negative information about mesh surgery. However, the unbiased government agency The National Institutes of Health performed a study of whether mesh should or should not be used for hernia surgery. Read the article by clicking on the logo to the right:
Patients can read more on our ‘Truths About Hernia Mesh‘ page.
About Hernia MeshDr. Harris discusses the benefits of using hernia mesh and why 99% of hernia specialists use mesh during surgery.
Dr. Harris specializes in surgical repair for all hernia types. For patients who require a laparoscopic surgery, Dr. Harris commonly performs these procedures. When performing a tension free mesh hernia repair, Dr. Harris uses the latest and most advanced lightweight mesh available which significantly reduces pain and discomfort after the surgery. Many surgeons still use mesh which was invented 10 years ago which can increase the chances of post operative mesh pain. Today’s advanced mesh reduces those risks to almost zero.
Although open surgical hernia repair is still an important option for many patients, every patient should consider being seen by a surgeon who can perform advanced laparoscopic hernia surgery and who uses the newest lightweight mesh. Only a small handful of the hundreds of general surgeons in Orange County, Los Angeles, Riverside and San Diego have the experience to perform hernia surgeries using laparoscopic techniques and use cutting edge lightweight mesh.