Ventral hernia repair

You will probably receive general anesthesia for this surgery. This will make you asleep and pain free.

If your hernia is small, you may receive a spinal or epidural block and medicine to relax you. You will be awake, but pain-free.

• Your surgeon will make a surgical cut in your abdomen.
• Your surgeon will find the hernia and separate it from the tissues around it. Then the contents of the hernia, such as intestines, will be gently pushed back into the abdomen. Your surgeon will only cut the intestines if they have been damaged.
• Strong stitches will be used to repair the hole or weak spot caused by the hernia.
• Your surgeon may also lay a piece of mesh at the weak area to make it stronger. Mesh helps prevent the hernia from coming back. Because of this, most hernia repairs are done with the use of reinforcing mesh.

Your surgeon may use a laparoscope to repair the hernia. This is a thin, lighted tube with a camera at the end. It lets your surgeon see inside your belly. Your surgeon inserts the laparoscope through a small cut in your belly and inserts the instruments through other small cuts. This type of procedure often heals faster, and with less pain and scarring. Sometimes, a surgical robot may be used for a hernia repair. The surgical robot also uses a laparoscopic approach to repair ventral hernias. Not all hernias can be repaired with laparoscopic surgery.

Ventral hernias are fairly common in adults. They tend to get bigger over time and there may be more than one in number.

Risk factors include:

• A large abdominal incision
• Being overweight
• Diabetes
• Straining when using the bathroom
• Coughing a lot
• Heavy lifting
• Pregnancy

Sometimes, smaller hernias with no symptoms can be watched. Surgery may pose greater risks for people with serious medical problems.

Without surgery, there is a risk that some fat or part of the intestine will get stuck (incarcerated) in the hernia and become impossible to push back in. This is usually painful. The blood supply to this area may become cut off (strangulation). You may experience nausea or vomiting, and the bulging area may turn blue or a darker color due to loss of blood supply. This is a medical emergency and urgent surgery is needed.

To avoid this problem, surgeons often recommend repairing a ventral hernia before it becomes incarcerated.

Get medical care right away if you have a hernia that does not get smaller when you are lying down or a hernia that you cannot push back in.

The risks of ventral hernia repair are usually very low, unless the person also has other serious medical problems.

Risks of having any anesthesia and surgery are:

• Reactions to medicines
• Breathing problems, such as pneumonia
• Heart problems
• Bleeding
• Blood clots
• Infection
• Recurrence of the hernia

A specific risk of ventral hernia surgery is injury to the bowel (small or large intestine). This is rare.

Your surgeon will see you and give you instructions.

An anesthesiologist will discuss your medical history to decide the right amount and type of anesthesia to use.

Tell your surgeon if:

• You are or could be pregnant
• You are taking any medicines, including medicines, drugs, supplements, or herbs you bought without a prescription
• You have been drinking a lot of alcohol, more than 1 or 2 drinks a day

Planning for your surgery:

• If you have diabetes, heart disease, or other medical conditions, your surgeon may ask you to see the health care provider who treats you for these conditions.
• If you smoke, it's important to cut back or quit. Smoking can slow healing and increase the risk for blood clots. Ask your provider for help quitting smoking.
• If needed, prepare your home to make it easier to recover after surgery.
• Ask your surgeon if you need to arrange to have someone drive you home after your surgery.

During the week before your surgery:

• You may be asked to temporarily stop taking medicines that keep your blood from clotting. These medicines are called blood thinners. This includes over-the-counter medicines and supplements such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and vitamin E. Many prescription medicines are also blood thinners.
• Ask your surgeon which medicines you should still take on the day of your surgery.
• Prepare your home for any problems you might have getting around after the surgery.
• Let your surgeon know about any illness you may have before your surgery. This includes COVID-19, a cold, flu, fever, herpes outbreak, or other illness. If you do get sick, your surgery may need to be postponed.

On the day of surgery:

• Follow instructions about when to stop eating and drinking.
• Take the medicines your surgeon told you to take with a small sip of water.
• Shower the night before or the morning of your surgery.
• Follow instructions on when to arrive at the hospital. Be sure to arrive on time.

Most ventral hernia repairs are done on an outpatient basis. This means that you will likely go home on the same day. If the hernia is very large, you may need to stay in the hospital for a couple of days.

After surgery, your vital signs such as pulse, blood pressure, and breathing will be monitored. You will stay in the recovery area until you are stable. Your surgeon will prescribe pain medicine if you need it.

Your surgeon or nurse may advise you to drink plenty of fluids along with a fiber-rich diet. This will help prevent straining during bowel movements.

Ease back into activity. Get up and walk around several times a day to help prevent blood clots.

Following surgery, there is a low risk that the hernia may come back. However, to reduce the risk of getting another hernia, you need to maintain a healthy lifestyle, such as maintaining a healthy weight.

Lu R, Holihan JL, Clements T, et al. Ventral hernias. In: Tyler DS, Hayes-Dixon A, Jo Hines O, et al, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 22nd ed. Philadelphia, PA: Elsevier; 2026:chap 80.

McNevin K, Liechty A, White N. Ventral hernia- MIS approaches. In: Ahmad SA, Pryor AD, eds. Shackelford's Surgery of the Alimentary Tract. 9th ed. Philadelphia, PA: Elsevier; 2026:chap 46.

Webb DL, Stoikes NFN, Voeller GR, Chandler RG. Open ventral hernia repair with onlay mesh. In: Rosen MJ, ed. Atlas of Abdominal Wall Reconstruction. 3rd ed. Philadelphia, PA: Elsevier; 2026:chap 12.

Updated by: John Meilahn, MD, General Surgeon, Wyndmoor, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.