Hernias

Abdominal Wall Hernia Repair

Hernias of the abdominal wall are common and occur when tissue pushes through a weakened area. While some hernias cause minimal symptoms, others can lead to discomfort, activity limitation, or more urgent complications. The goal of hernia repair is to restore the strength of the abdominal wall, relieve symptoms, and reduce the risk of future problems.

Whenever appropriate, I perform robotic-assisted hernia repair, which allows for precise reconstruction of the abdominal wall using minimally invasive techniques and durable mesh reinforcement. This approach often results in less pain, smaller incisions, and a faster recovery compared with traditional open surgery.

Types of Abdominal Wall Hernias We Treat

Inguinal Hernias

Inguinal hernias occur in the groin and are more common in men, though they can affect women as well. Symptoms may include a bulge, pressure, or pain with lifting, coughing, or standing.

Most inguinal hernias are repaired using a robotic TAPP (Transabdominal Preperitoneal) approach. This technique allows the hernia to be repaired from inside the abdominal wall, placing mesh in a protected space that reinforces the weakness while avoiding tension on surrounding tissues.

Umbilical Hernias

Umbilical hernias develop near the belly button and may be present for years before becoming symptomatic. Larger or symptomatic umbilical hernias often benefit from mesh reinforcement to reduce the risk of recurrence.

Robotic repair allows for careful closure of the defect and precise mesh placement, even for hernias that appear small on the surface but are more complex beneath the skin. Smaller umbilical hernias are often repaired using on incision and do not usually require mesh.

Incisional Hernias

Incisional hernias occur at the site of a prior surgical incision and can vary widely in size and complexity. These hernias may enlarge over time and can affect both comfort and abdominal wall function.

Robotic surgery provides excellent visualization for incisional hernia repair and allows for advanced techniques to reconstruct the abdominal wall while minimizing the need for large open incisions.

Epigastric Hernias

Epigastric hernias occur in the upper midline of the abdomen, often between the breastbone and the belly button. They may cause localized pain or tenderness, particularly with activity.

These hernias are well suited for minimally invasive repair, especially when symptoms are present or the defect is enlarging.

Robotic Hernia Repair & Mesh Reinforcement

Robotic-assisted surgery enhances precision and control during hernia repair. The robotic platform allows for:

Small incisions
Improved visualization of the abdominal wall
Careful dissection around nerves and blood vessels
Secure mesh placement in optimal anatomical planes

Mesh is commonly used in abdominal wall hernia repair to reinforce weakened tissue and reduce the chance of recurrence. The type of mesh and repair technique is individualized based on the hernia location, size, prior surgeries, and patient-specific factors.

Advanced Reconstruction & Component Separation (TAR)

In more complex or larger hernias, additional techniques may be required to restore the abdominal wall. One such approach is component separation, including Transversus Abdominis Release (TAR).

These advanced techniques allow the abdominal muscles to be repositioned and brought back together in a functional, tension-free manner. Not every patient needs this level of reconstruction, but it is an important option for selected cases and is most often performed using minimally invasive or robotic techniques when appropriate.

Outpatient vs. Urgent Hernia Surgery

Many hernia repairs are performed electively and on an outpatient basis, allowing patients to go home the same day. However, hernias can occasionally become incarcerated or strangulated, leading to severe pain, nausea, vomiting, or bowel obstruction.

If you are viewing this information while being evaluated in the emergency department, surgical decisions are made based on the urgency of the situation and patient safety. When possible, minimally invasive techniques are still considered, even in urgent cases.

Recovery After Hernia Surgery

Recovery varies depending on the type of hernia and the complexity of the repair, but most patients experience:

Discharge home the same day
Mild to moderate soreness for several days
Early walking encouraged
Return to light activities within 1–2 weeks

Heavy lifting and strenuous activity are usually restricted for several weeks to allow proper healing of the repair. Specific recovery guidelines are discussed in detail before and after surgery to ensure a safe return to normal activity.

Long-Term Outcomes & Follow-Up

Hernia repair is designed to be a durable, long-term solution. Follow-up visits allow us to monitor healing, address any concerns, and guide a gradual return to full activity. My approach emphasizes careful technique, appropriate mesh use, and individualized planning to minimize recurrence and optimize outcomes.