Abdominal hernia – surgical treatment

What is an abdominal hernia?

The group of abdominal hernias includes, among others, inguinal, umbilical, femoral, linea alba, and lumbar hernias. A hernia occurs when, due to weakening or damage to the abdominal wall, organs—most commonly sections of the intestine or peritoneum—protrude beyond its boundaries. A hernia can be congenital or acquired. In adults, factors contributing to its development include previous surgeries, injuries, heavy lifting, pregnancy, childbirth, obesity, and the natural aging process, which causes a loss of tissue elasticity.

An untreated hernia not only grows larger over time, but can also lead to serious complications—such as intestinal obstruction and ischemia. For this reason, surgical removal is recommended in every case.

How does the procedure work?

Abdominal hernia surgery is performed under general anesthesia and typically lasts 1 to 2 hours, depending on the extent of the hernia. The procedure begins with an incision at the site of the hernia, through which the surgeon gains access to the abdominal cavity. Next, the hernial sac is carefully separated or incised, and the displaced organs are returned to their proper positions.

After reducing the hernia, the surgeon proceeds to reconstruct the abdominal wall. In most cases, a special surgical mesh is used to reinforce the weakened tissues and significantly reduce the risk of recurrence. In cases of very extensive defects, the mesh serves as the primary reinforcement without the need to suture the tissues. Finally, the surgeon carefully sutures the subcutaneous tissues and skin, and the wound is covered with a sterile dressing.

Preparation for the procedure

Abdominal hernia surgery requires a prior surgical consultation and the following tests: complete blood count, coagulation parameters (APTT, INR), electrolytes, glucose, ECG, blood typing, and a urinalysis. About a week before the procedure, you must stop taking anticoagulants and certain pain medications—detailed guidelines will be provided by your attending physician.

The patient should also avoid heavy meals and alcohol in the days leading up to the procedure and arrive on an empty stomach on the day of the surgery.

Recovery after surgery

The recovery period depends on the size of the hernia and the patient’s individual condition. The hospital stay usually lasts 1–2 days. During the first few weeks after surgery, patients should avoid physical exertion, heavy lifting, and sudden movements. It is recommended to wear an abdominal support belt, which aids the healing process and stabilizes the abdominal wall.

You can resume light activities, such as walking, after about 2 weeks, while full physical activity is recommended after 2–3 months. Your diet should consist of easily digestible foods rich in fiber, which helps prevent constipation and excessive pressure in the abdominal cavity. The surgical wound requires regular dressing changes, and the stitches are usually removed after 7–10 days.

Contraindications to the procedure

Although surgery for an abdominal hernia is necessary, in some cases it should be postponed or preceded by treatment of any underlying conditions. Contraindications include:

• active infections of the skin and subcutaneous tissues,
• uncontrolled diabetes,
• coagulation disorders,
• circulatory failure and heart disease,
• hypertension,
• anemia,
• pregnancy.