The bigger the defect the bigger the operation required to fix it. Under certain circumstances the hernia may be watched and followed closely by a physician. These situations are unique to those individuals who are high operative risks, ie, severe heart or lung disease, or bleeding problems. Of course, even in the high risk person, if the symptoms become severe or if strangulation occurs, then an operation must be performed. There are 5-10 different approaches and can be performed routinely with local and intravenous sedation.
Open repair is generally painful with a relatively long recovery period.
It is usually performed under general anesthesia but spinal anesthesia is an option. Local anesthesia can be used under special circumstances. As with the open operation, bleeding and infection can occur. The risk of nerve injury appear to be less than in open repair, as does the potential for recurrences of the hernia. Take it easy the first few days.