Updated May 2025
1. First of All, Don’t Panic!
Injuries, illness, and other medical diagnoses often elicit anxiety and an overall uneasiness. Hernias are quite common, and in the hands of a specialist, they are very reliably repaired.1-4 So, stay calm! Maybe that’s easier said than done, but trust the process. You can see what the most frequently asked questions are related to your hernia in this comprehensive section.
Although hernia strangulation is rare, it is a serious and potentially life-threatening condition.5 Make sure you know the warning signs, and seek emergency medical attention right away if you suspect you may be experiencing it. Check out more information about when hernias become an emergency here.
2. Choose a Surgeon
The first step for anyone with a hernia (which may or may not require surgical repair) is to choose a hernia specialist who’s right for them. Patients do better when they are cared for by a specialist who does a high volume of hernia repairs like yours.6-11 Ask your primary care provider about their recommendations. Conduct some online research about local specialists in your area. Talk to family members and friends who have had hernia experiences. When you find a surgeon with whom you feel confident, it will make the hernia repair journey a lot smoother.
3. Consult with Your Surgeon
A consultation with your surgeon will include a discussion regarding your hernia symptoms, an examination, and next steps regarding surgery, if recommended. Boston Hernia uses a team approach with our surgeons and physician assistants – this approach has been shown to result in better outcomes for our patients.12 Together, they’ll answer your questions and lay out a plan of action for the safest and most proven surgical procedure. When you go into this meeting, be prepared with some general information including:
- Symptoms: How long have you had discomfort? Have your symptoms changed or worsened recently?
- Previous Surgery & Medical Information: Are you on any medications? Do you have any medical conditions? Have you had hernia surgery before and if so, do you have copies of past operative notes? Have you had any imaging? Bringing copies of operative notes or imaging reports/discs to your initial visit is recommended.
- Questions: Write down any questions you have about hernias, surgical repairs, and postop recovery. Your medical team will answer them during your initial consultation. Here are 7 questions you should ask your surgeon.
4. Check Your Health Insurance Benefits
Work with your chosen surgeon and team to ensure that all the insurance and payment details are ironed out prior to your surgery date. Many insurance companies still require referrals from your primary care provider. These referrals must be in place before you can be seen by most hernia specialists. Please check with your own insurance company well before your appointment. This will eliminate the stressors that exist when you’re unsure about the financial aspects of your surgery.
5. General Wellness Before Surgery
Take good care of yourself in the days and weeks leading up to your surgery. Eat well, stay hydrated, exercise at levels that do not cause excessive pain to the hernia and get plenty of sleep. Remember #1 — try to keep a positive outlook – over 1 million people go through hernia surgery each year in the US.
6. Complete Any Pre-Op Tests
People with pre-existing medical conditions and those over 65 may sometimes require pre-op blood work or ECG. Your surgeon will work closely with the surgery center or hospital. They will decide if you need to have testing based on your age, fitness level, existing medical conditions, prior surgeries, medication use, etc. The most common preoperative tests are blood tests and ECG. These tests are normally done a week or two prior to surgery. They can often be done in your primary care provider’s office.
7. Understand Your Preoperative Instructions
During the week before surgery, you’ll want to follow all your preoperative instructions regarding medications, including:
- If you regularly use blood thinners or aspirin, your primary care provider or cardiologist will advise you if it is safe to stop these medications before surgery.
- Do not take dietary or herbal supplements like St. John’s Wort or Vitamin E.
- If you have a heart condition and take heart medication, make sure to touch base with your primary care provider or cardiologist. Most patients take these important medications even on the morning of surgery with a sip of water.
- If your doctor allows you to take any medications on the day of surgery, take them with only a small sip of water. Please follow instructions from the surgery center or hospital in regards to how long to stop eating leading up to surgery. If these instructions are not followed, your surgery may be postponed for your own safety.
Your surgical team will likely give you instructions for bathing, shaving, eating and drinking before surgery. Generally, our patients at Boston Hernia are advised:
- Patients typically should not eat or drink anything after midnight the night before surgery. Follow instructions given from the surgery center or hospital. Surgery may be postponed or cancelled if these instructions are not followed.
- Take a bath or shower before you come in for your surgery.
- Do not apply any lotions, perfumes, deodorants, or nail polish before surgery.
- Please don’t shave the surgical site yourself. Your surgical team will take care of that.
- Take off your jewelry including earrings and piercings.
- If you wear contact lenses, you’ll be asked to remove them before your procedure.
8. Know What To Expect After Surgery
Review your surgeon’s postoperative instructions online whenever possible. During your consultation with your surgeon, you should learn what to expect after surgery. You should know what to expect in terms of pain, medication, and activity restrictions. You should know when you can drive after surgery – it’s never the day of surgery. Returning to work depends on what you do and what kind of hernia you are having repaired. Don’t forget to ask these important questions during your initial consultation.
References:
1. Ma Q, Jing W, Liu X, Liu J, Liu M, Chen J. The global, regional, and national burden and its trends of inguinal, femoral, and abdominal hernia from 1990 to 2019: findings from the 2019 Global Burden of Disease Study – a cross-sectional study. Int J Surg. 2023 Mar 1;109(3):333-342. doi: 10.1097/JS9.0000000000000217. PMID: 37093073; PMCID: PMC10389329.
2. Wang F, Ma B, Ma Q, Liu X. Global, regional, and national burden of inguinal, femoral, and abdominal hernias: a systematic analysis of prevalence, incidence, deaths, and DALYs with projections to 2030. Int J Surg. 2024 Apr 1;110(4):1951-1967. doi: 10.1097/JS9.0000000000001071. PMID: 38265437; PMCID: PMC11020045.
3. Berndsen MR, Gudbjartsson T, Berndsen FH. Is a Technically Challenging Procedure More Likely to Fail? A Prospective Single-Center Study on the Short- and Long-Term Outcomes of Inguinal Hernia Repair. Surg Res Pract. 2018 Apr 1;2018:7850671. doi: 10.1155/2018/7850671. PMID: 29808170; PMCID: PMC5901827.
4. Nijs J, Miserez M, Meylemans D, Tollens T. Patient Satisfaction After Inguinal Hernia Surgery: Literature Review of an Overlooked Patient-Reported Outcome Measure. Surg Technol Int. 2022 Nov 15;41:189-196. doi: 10.52198/22.STI.41.HR1626. PMID: 36326045.
5. Mizrahi H, Parker MC. Management of asymptomatic inguinal hernia: a systematic review of the evidence. Arch Surg. 2012 Mar;147(3):277-81. doi: 10.1001/archsurg.2011.914. PMID: 22430913.
6. Morche J, Mathes T, Pieper D. Relationship between surgeon volume and outcomes: a systematic review of systematic reviews. Syst Rev. 2016 Nov 29;5(1):204. doi: 10.1186/s13643-016-0376-4. PMID: 27899141; PMCID: PMC5129247.
7. Maneck M, Köckerling F, Fahlenbrach C, Heidecke CD, Heller G, Meyer HJ, Rolle U, Schuler E, Waibel B, Jeschke E, Günster C. Hospital volume and outcome in inguinal hernia repair: analysis of routine data of 133,449 patients. Hernia. 2020 Aug;24(4):747-757. doi: 10.1007/s10029-019-02091-8. Epub 2019 Nov 30. PMID: 31786700; PMCID: PMC7395912.
8. Aquina CT, Kelly KN, Probst CP, Iannuzzi JC, Noyes K, Langstein HN, Monson JR, Fleming FJ. Surgeon volume plays a significant role in outcomes and cost following open incisional hernia repair. J Gastrointest Surg. 2015 Jan;19(1):100-10; discussion 110. doi: 10.1007/s11605-014-2627-9. Epub 2014 Aug 14. PMID: 25118644.
9. Christophersen C, Fonnes S, Baker JJ, Andresen K, Rosenberg J. Surgeon Volume and Risk of Reoperation after Laparoscopic Primary Ventral Hernia Repair: A Nationwide Register-Based Study. J Am Coll Surg. 2021 Sep;233(3):346-356.e4. doi: 10.1016/j.jamcollsurg.2021.05.023. Epub 2021 Jun 7. PMID: 34111532.
10. AlJamal YN, Zendejas B, Gas BL, Ali SM, Heller SF, Kendrick ML, Farley DR. Annual Surgeon Volume and Patient Outcomes Following Laparoscopic Totally Extraperitoneal Inguinal Hernia Repairs. J Laparoendosc Adv Surg Tech A. 2016 Feb;26(2):92-8. doi: 10.1089/lap.2015.0368. Epub 2016 Jan 28. PMID: 26863294.
11. Bittner R, Unger S, Köckerling F, Adolf D. Is the annual hospital volume associated with recurrence and chronic postoperative inguinal pain (CPIP) syndrome after inguinal hernia repair in laparo-endoscopic or open mesh technique (Lichtenstein)? Surg Endosc. 2025 May;39(5):2882-2901. doi: 10.1007/s00464-025-11619-2. Epub 2025 Mar 17. PMID: 40097851.
12. Smith, S. M., et al. (2018). Team-based care and patient outcomes: A systematic review. Journal of Primary Care & Community Health.
About Boston Hernia
Dr. Michael Reinhorn and Dr. Nora Fullington are leading specialists in inguinal hernia and umbilical hernia surgery. Their mission is simple- to provide better outcomes to patients needing hernia surgery. They achieve this by using evidence-based surgical methods and approaching abdominal core health holistically. Together with their skilled physician assistant teams, they perform approximately 1,000 hernia surgeries each year. Boston Hernia is one of only a few practices that performs the 4-layer no-mesh Shouldice technique and the advanced open preperitoneal repair. We deliver what patients really want- a tailored approach to anesthesia, consideration of mesh vs no-mesh repairs, laparoscopic and open surgery, and non-surgical interventions. Boston Hernia contributes to the continuous advancement of hernia care by tracking patient outcomes, participating in mission-driven organizations, lecturing across the U.S., and publishing medical literature. In addition to serving the Greater Boston area at our offices in Wellesley, MA and Derry, NH, we accommodate out-of-state patients with long-distance scheduling.
