If you’ve been diagnosed with a hernia, one of your first questions is likely what happens next? The good news is that you have a range of treatment options, but the right approach for you depends on your individual situation. This article will cover things to help you have an informed conversation with your doctor. Your health care provider will help you to decide which treatment option is right for you. Learn about the different options below.

A hernia occurs when an organ or fatty tissue squeezes through a weak spot in surrounding muscle or connective tissue, often (but not always) creating a noticeable bulge. They typically occur in weaker areas like the abdominal wall or groin. Most hernias are external and often create a bulge that you can see. But a hernia can also be internal, meaning it remains inside the body and may be unnoticeable. While some hernias are asymptomatic and may not require immediate medical attention, over 1 million Americans every year receive a hernia repair surgery.^1,2

There are multiple types of hernias, with the most common being inguinal (inner groin). An estimated 1 in 4 men and 1 in 50 women will require surgery for an inguinal hernia during their lifetime.³

It’s important to know that hernias will not heal on their own—surgery is required to repair a hernia. Speak to your doctor about the treatment options available to you based on your individual case.

While more traditional hernia repair methods usually consisted of a permanent synthetic mesh used in an open repair, today's surgical landscape has evolved significantly. Patients now have options when it comes to surgical methods, as well as materials (i.e., mesh) used during surgery. These options allow surgeons to tailor their approach to each patient’s unique needs and medical history, and allowing for patient advocacy in a shared care approach.

Surgical methods

• Open repair: In an open repair, an incision is made at the site of the hernia. The mesh is placed between layers of muscle for a durable repair.⁴ Depending on your surgical history, such as if a previous surgery has caused scar tissue, doctors may opt for this more traditional approach.
• Laparoscopic repair: Laparoscopy is a type of minimally invasive surgery that only requires a small ‘keyhole’ incision. Laparoscopic repairs use a small camera and specialized minimally invasive tools for accuracy. Patients may experience a faster recovery, less pain, and fewer complications following laparoscopic repair compared to an open surgery.^2,5
• Robotic repair: Similar to laparoscopic repair, a robotic hernia repair is a minimally invasive surgery requiring small incisions where the surgeon controls the procedure from a specialized robotic console.⁵ Patients may also experience a faster recovery, less pain, and fewer complications following robotic surgery compared to an open surgery.^2,6
   

While a hernia will not repair itself or go away on its own, there are few instances where it’s reasonable to adopt a “watchful waiting” approach, such as when the hernia is small in size and not growing, asymptomatic, and easily goes back in. If you decide with your doctor on a non-surgical watch-and-wait approach, it’s important to avoid doing activities that may aggravate the hernia such as heavy lifting, straining, or intense physical workouts. Your doctor will advise you on limitations for your specific case.

Although rare, it is also possible for a hernia to become incarcerated or strangulated over time if it is not treated—which can cause intestinal blockage or a cutoff of blood supply requiring emergency surgery. It's important to understand the telltale signs that you should seek immediate medical attention.

To decide what’s best for you, discuss the benefits and risks of both non-surgical and surgical treatment options with your doctor. If you've been recommended the ‘watch and wait’ method by your doctor, read our blog with helpful guidance here.
 

Surgeons often use surgical mesh during hernia repair to reinforce the weakened area and help reduce the chances of the hernia coming back (recurrence). It is generally accepted that most hernia repair surgeries in the U.S. use mesh.⁸ Mesh acts as a supportive layer that strengthens the abdominal wall while your body heals. In many cases, using mesh may also improve patient outcomes through shorter operative times and a minimized recovery time.¹ Understanding why mesh is used—and how it helps support the repair—can help you feel more confident as you discuss treatment options with your doctor.
 

In addition to advancements in surgical techniques, today’s hernia repairs may also benefit from innovations in mesh materials. Surgeons now have a range of mesh options designed to support different hernia types, surgical approaches, and patient needs. Understanding the basic differences between these materials can help you feel more informed as you discuss your treatment plan with your doctor.

Types of hernia mesh

• Synthetic mesh: Synthetic meshes made from plastic materials (e.g., polypropylene, polyester, etc.) are permanent implants used to repair hernias. These non-absorbable meshes remain in the body to provide support to the site of the repair and are considered a more traditional approach.^9,10
• Bioabsorbable mesh: Bioabsorbable (or “resorbable”) mesh is a fully absorbable mesh made of natural biomaterials. The mesh is designed to degrade over time leaving new tissue growth to support the site of the repair.¹⁰ For patients seeking an alternative to synthetic (permanent) mesh, long-term bioabsorbable mesh works naturally with your body to rebuild tissue.
• Biological graft: A biological graft is an implant derived from animal or human tissue. It is most often used in complicated hernia repair procedures. Similar to bioabsorbable mesh, biologic grafts are intended to degrade completely over time to continue supporting the repair even after the graft dissolves.¹⁰
   

Despite reduced rates of recurrence, there are situations where the use of certain surgical mesh may not be recommended or can lead to complications following hernia repair. Risk factors (such as obesity, smoking, and diabetes) may have an impact on complications and what type of mesh your doctor may recommend. The most typical complications include:

• Pain, infection, inflammation
• Hernia recurrence
• Adhesion
• Bowel obstruction
• Mesh migration (or movement)
• Mesh shrinkage (contraction)

Be sure to talk to your doctor about your specific circumstances to determine the best options or alternatives for hernia repair.
 

All surgery carries risk, medical procedures are not without their potential for complications, and hernia surgery is no different. Risk factors may have an impact on complications and what type of repair your doctor may recommend. Some potential risks of hernia surgery may include (but are not limited to):

• Bruising, infection, bleeding, and/or pain at the incision site
• Nausea and vomiting
• Accumulation of fluid (seroma) or swelling around the incision
• Chronic pain (long-term risk)
• Hernia recurrence
• Injury to blood vessels or nearby organs
• Blood clots and deep vein thrombosis

Talk to your doctor about the likelihood of complications and what you can do to help avoid them.
 

Hernias can return after surgery. On average, recurrence rates typically vary from 1-20% with 20% being for the most complex cases. The likelihood of a hernia recurrence is dependent on a handful of factors, including type, size, and location of the hernia, surgical technique, mesh usage, patient risk factors, and/or whether the hernia was previously repaired.¹³ If you’re concerned about your chances of having a hernia return, speak openly about it with your doctor. You can use our Doctor Discussion Guide for guidance.
 

If you have a hernia, you have a range of treatment options for repair. Being informed about your options is an important step towards the hernia repair journey. Ready for the next steps? Use our Surgeon Finder to locate a nearby hernia surgeon and see what may be right for you.

The guidance provided in this article follows general rules that should be discussed with your doctor. This article is for informational and educational purposes only. It does not substitute for medical advice. If in doubt, always consult your doctor.