Hernia Repair Surgery: Techniques, Advances, and Outcomes in Treating Abdominal Wall Defects
Hernia repair is one of the most commonly performed surgical procedures worldwide, addressing defects in the abdominal wall through which internal organs or tissues protrude. Hernias may occur in various anatomical regions, including the inguinal, ventral, incisional, femoral, and umbilical areas.
They develop due to increased intra-abdominal pressure, muscle weakness, obesity, chronic coughing, heavy lifting, pregnancy, prior surgeries, aging, and genetic predisposition. Untreated hernias may enlarge, cause pain, and lead to life-threatening complications like strangulation.
Surgical hernia repair techniques include open repair and minimally invasive laparoscopic or robotic-assisted repair. In open surgery, the defect is closed using sutures and reinforced with mesh to reduce recurrence. Laparoscopic hernia repair involves small incisions, insertion of a camera and instruments, and mesh placement, offering reduced postoperative pain, quicker recovery, and minimal scarring. Robotic hernia repair further enhances precision, dexterity, and visualization, particularly in complex or recurrent hernias.
Mesh materials have evolved significantly, ranging from synthetic polypropylene meshes to advanced bio-absorbable and hybrid meshes that integrate with tissue and reduce infection risk. Tissue repair without mesh is still used in small hernias or cases where infection risk is high. Enhanced recovery after surgery (ERAS) protocols, pain management advances, and improved suturing and fixation systems have improved surgical outcomes.
Latest advancements include 3D-printed patient-specific meshes, biologic implants, nano-coated materials, real-time imaging guidance, and remote robotic telesurgery capabilities. While hernia surgery is generally safe, risks include chronic pain, infection, recurrence, and mesh-related complications. Patient counseling, lifestyle modification, weight control, and postoperative rehabilitation play essential roles in long-term success. Hernia repair continues to progress through innovation in biomaterials, minimally invasive techniques, and enhanced patient care pathways.