Open hernia surgery is the standard of care in hernia repair. In open surgery, the skin and fat over a hernia are opened and the hole in the muscle is located. Either a no mesh tissue repair or a mesh repair is then performed. 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.

The defect (or hole) in the muscle is often closed with sutures. This provides one layer of protection against the hernia coming back. If a no mesh is being performed, a patient’s natural tissues are used to reinforce the hernia repair. If a mesh repair is being performed, a small mesh is used to reinforce the area of the hernia defect and the muscle around the hole. The mesh reinforces the weakened muscle layer again providing help to prevent a recurrent hernia. Patients can be a candidate for a no mesh hernia repair if they fit acceptable criteria.

Open Inguinal Hernia Surgery Video

In the video below, Dr. Harris narrates an open inguinal hernia repair done at California Hernia Specialists’ hernia center.

Open Bilateral Inguinal Hernia Surgery Video

In the video below, Dr. Harris narrates an open bilateral inguinal hernia repair done at California Hernia Specialists’ hernia center. This patient had prior prostate surgery and thus was not a good candidate for a laparoscopic approach.

Open Inguinal Scrotal Hernia with Colon Involvement Video

In this video, Dr. Harris showcases a large inguinal hernia which was extending down into the scrotum. The hernia had colon inside of it and was repaired at our California Hernia Specialists’ hernia center.

Open Hernia Surgery – Umbilical and Ventral

Umbilical and ventral hernia repairs are almost always best done open. During open surgery, a small incision is made in the crease under the belly button or over the hernia bulge. The belly button or the overlying tissues and fat are exposed and the hole in the muscle is found. Depending on the size of the muscular defect and the healthiness of the surrounding muscles, either the hole is closed primarily with sutures performing a no mesh natural tissue repair or a small a mesh is placed through the hole.

If a mesh is used, it is then sutured to the surrounding healthy muscle in several locations and usually the muscles are closed over the hernia mesh. Once the mesh is securely fastened to the muscle, the belly button is replaced down to the muscle or fat and the skin is sutured 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.

Tension Vs. Tension-Free Hernia Repair

The term ‘tension’ or ‘tension-free’ is commonly used when describing a particular hernia surgery. Hernias are caused by a weakening of the abdominal muscles which over time develops into a true hole. For patients who desire a no mesh repair, the muscles surrounding the hernia defect are sewn back together to close the hernia. This pulling together of the muscles creates tension which his why primary (no mesh) repairs are considered ‘tension repairs’.

In many patients, whether due to the size of the hernia or the patient, it’s not advisable for a surgeon to simply pull the muscles back together. In those cases, most hernia specialists today utilize a mesh to help strengthen the muscles and the hernia repair. When using a mesh, the muscles themselves are often not sewn together limiting the tension on the tissues providing a ‘tension free’ repair. Instead, a mesh is placed over or under the hole in the muscle to prevent anything from pushing through the abdominal wall.

Mesh Versus No Mesh Hernia Repairs

While a no mesh hernia repair is an option for some patients, many others will strongly benefit from the use of a mesh. 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 and found that in the vast majority of patients, a mesh is the recommended approach to repairing a hernia. They also found that in the right hands, the use of a mesh causes little if any additional risks to the patient. Read the article by clicking on the logo below:

Patients can read more on our ‘Truths About Hernia Mesh‘ page.

Our Approach

Our office specializes in the surgical repair for all hernia types. We provide patients with the full spectrum of treatment options from open no mesh hernia repairs to advanced minimally invasive laparoscopic techniques. Dr. Harris and our team perform over 500 hernia repairs each year making us the busiest center on the West Coast, and one of the top 3 in the country.

For over 10 years we have partnered with the Abdominal Core Health Quality Collaborative (ACHQC) to track the outcome of every surgery we perform. Year over year, our nationally leading outcome data shows a lower chance of hernia recurrence and a lower risk of developing chronic pain – data which we actively publish on our website. Our commitment to cutting edge hernia care, the full spectrum of surgical options, as well as research and transparency in our data, helps ensure you will have the best outcome after your hernia surgery.