Open repair of a hernia is typically performed when someone has a single hernia and has never had one before. In this procedure, the surgeon makes an incision in the groin or abdomen, returns the muscle, organ, or other tissue to its original position, and removes the sac that held the hernia. The surgeon may either sew together healthy muscle or insert a mesh to reinforce the weakened area.
There are several types of open repairs. All take about one hour to perform and require general anesthesia.
At NYU Langone, Lichtenstein repair surgery is usually used to correct inguinal hernias. It is a “tension-free” repair, meaning a mesh material is used to reinforce the weakened area instead of using sutures, which can create tension in that area of the body, similar to that which caused the hernia.
In this procedure, a doctor makes an incision in the groin, returns the tissue or organ to its original location in the abdomen, and then closes off and removes the sac.
Next, he or she places a mesh material over the weakened area of the inguinal canal. In time, new tissue attaches to the mesh to reinforce the abdominal wall, relieving tension and reducing the risk of a recurrent hernia.
In a Shouldice hernia repair, the surgeon returns the tissue and organs inside an inguinal hernia to their original position. Next, he or she creates flaps with four layers of tissue, or fascia. He or she then overlaps the layers and uses steel sutures to strengthen the weakened area of the inguinal canal.
In a Bassini hernia surgery, the surgeon pulls together and sutures, or sews, muscles to cover the hole in the inguinal canal. This repairs the hernia. Bassini repair is typically used if mesh repair isn’t possible, such as when a part of the intestine has been removed due to a strangulated hernia.
Plug and Patch Repair
In a plug and patch hernia procedure, the surgeon reaches the hernia through an incision in the groin or abdomen and places a mesh plug into the hole to the hernia. It’s then secured with a patch that’s sutured in place.