Ventral Hernia Repair

Every year in the U.S., surgeons repair nearly 384,000 ventral hernias.²¹ As with any treatment for a ventral hernia, it begins with a discussion with your doctor about the best course of action to deal with your specific problem.

Traditionally this surgery is performed using a single large incision or “open” procedure. However, as the technology has advanced, more and more are being performed using minimally invasive procedures (with small incisions), which may provide important advantages during your recovery.

Here are the two options surgeons have for ventral hernia repair:

Generally in an “open” ventral hernia repair, the surgeon:

• Makes an incision through skin, muscle, and protective tissue in your abdomen at the site of the hernia. The size of the incision depends on the size of the hernia.
• Dissects the hernia sac free and removes adhesions.
• Pushes the contents of the hernia into place.
• Sometimes places artificial mesh over the hernia, and then binds the abdominal wall to the mesh.
• Closes the incision with sutures or surgical staples.

In a minimally invasive ventral hernia repair, the surgeon:

• Makes several ¾-inch incisions apart from the hernia.
• Inflates your abdomen with air or carbon dioxide.
• Inserts a miniature camera called a laparoscope into your abdomen through one of the incisions, and watches the images on a video monitor.
• Dissects the hernia sac free and removes adhesions.
• Uses advanced, long-handled instruments inserted through the other incisions to pull the organs back into proper position, and then reinforces the abdominal wall with artificial mesh from underneath.
• Closes each small incision with sutures.

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Minimally Invasive Ventral Hernia Repair

Today, surgeons can choose traditional “open” surgery (which requires a large incision), as well as a minimally invasive approach (with smaller incisions). In fact, about 35% of these surgeries in the U.S. are performed using a minimally invasive approach. ²¹ In a few years that number of laparoscopic ventral hernia repairs is expected to jump to 60%. ¹⁵

Minimally invasive procedures are not for everyone. Only your surgeon can determine if it is the right choice for you. This is based on several factors, including:

• Obesity
• History of prior abdominal surgery where dense scar tissue may exist
• Inability to safely view the organs
• Bleeding problems during the operation
• Underlying medical conditions

The decision to what type of surgery should be performed can only be made based on a discussion with your surgeon. That’s why it’s helpful to know your surgical options.

Benefits for Ventral Hernia Repair

Minimally invasive ventral hernia repair surgery requires your surgeon to make a few small incisions. It’s just as effective as “open” surgery (which requires a large incision), and has significant benefits, including:

• Less pain after surgery – requiring less painkilling medication.¹⁹
• Less scarring – because of the smaller incisions
• A shorter hospital stay – you can usually go home within 24 hours, and your surgery may even be done on an outpatient basis.
• A faster recovery – on average, a patient who undergoes a minimally invasive procedure (with small incisions) may return to normal activities 13 days earlier and may be back to work 22 days earlier than patients who had “open” surgery (which requires a large incision). ²⁰
• Less chance of complications – the risk of complications for these patients were 14% versus 27% for patients who undergo “open surgery (using large incisions).¹³
• Lower recurrence – patients had a 4.7% chance of the hernia occurring again after a minimally invasive procedure (with small incisions) versus 12-24% for “open” surgery (with a large incision).¹⁴

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Talking to your Surgeon about Ventral Hernia Repair

Once you’re referred to a surgeon, ask questions. Learn as much as you can about your surgeon, the surgery, and your own condition. Here are a few questions to get the conversation started.

• Is minimally invasive surgery an option for my ventral hernia repair?
• What are the benefits of a minimally invasive surgery for a ventral hernia repair?
• What are the risks of an MIP for a ventral hernia repair?
• How many ventral hernia repair surgeries have you performed using MIP?
• How often do you have to switch from an MIP for hernia repair to a conventional ventral hernia repair during surgery?
• Does this seem like a routine ventral hernia repair? Is there any reason to be concerned about particular complications that may arise during the surgery?
• Do my symptoms indicate that there’s a chance you may need to switch to a conventional ventral hernia repair?
• How long will it take for me to recover from having my ventral hernia repaired?
• When will I be able to leave the hospital?
• When can I resume my normal activities, including school, work, exercise, sexual activity, and/or recreation?

Don’t like the answers you get? Consider getting a second opinion. It’s important that you feel comfortable with the treatment and the surgeon you’ve selected.

Finding a Surgeon

To locate a surgeon in your area experienced in minimally invasive ventral hernia repair, use our Find a Physician tool.