Hernias usually don’t get better on their own. They tend to get bigger. In rare cases, they can lead to life-threatening complications. That’s why doctors often recommend surgery. But not every hernia needs treatment right away. It depends on the size and symptoms.
Do I Need Hernia Surgery?
Your doctor will likely recommend it if any of these things happen:
- Tissue (such as the intestine) becomes trapped in the abdominal wall. This is called incarceration. If left untreated, it may lead to strangulation. That’s when the blood supply to the tissue gets cut off.
- The hernia becomes strangulated. This can cause permanent damage or even death. Call your doctor right away if you have a fever or nausea, sudden pain that gets worse, or a hernia that turns red, purple, or dark. You’ll need emergency surgery.
- The hernia causes pain or discomfort, or it’s growing larger.
You may be able to wait to have surgery if:
- Your hernia goes away when you lie down, or you can push it back into your belly
- It’s small, and causes few -- or no -- symptoms (these may never need surgery)
Talk to your doctor. He’ll monitor your hernia during your yearly physical.
Nearly all children and adults can have hernia surgery. If you’re seriously ill or very frail, you may choose not to have an operation. Your doctor can help you weigh the benefits of the procedure against your ability to recover.
Types of Hernia Surgery
Your doctor can remove your hernia in one of two ways. Both are done at a hospital or surgery center. You’ll usually go home within a few days. In many cases, you’ll be able to go home the same day as your procedure.
Open surgery: Before the operation, you’ll receive local or spinal anesthesia (it numbs the lower part of your body). Or you may receive general anesthesia (you’ll get medication through an IV so you’ll be asleep during the procedure).
The surgeon makes a cut (incision) to open your skin. He’ll gently push the hernia back into place, tie it off, or remove it. Then he’ll close the weak area of the muscle -- where the hernia pushed through -- with stitches. For larger hernias, your surgeon may add a piece of flexible mesh for extra support. It’ll help keep the hernia from coming back.
Laparoscopic surgery: In this surgery, your abdomen is inflated with a harmless gas. This gives the surgeon a better look of your organs. He’ll make a few small incisions (cuts) near the hernia. He’ll insert a thin tube with a tiny camera on the end (laparoscope). The surgeon uses images from the laparoscope as a guide to repair the hernia with mesh. For laparoscopic surgery, you’ll receive general anesthesia.
Recovery is usually faster with laparoscopic surgery: On average, patients are back to their normal routine a week sooner than with open surgery.
What kind of surgery you’ll need often depends on your hernia’s size, type, and location. Your doctor will also consider your lifestyle, health, and age.
Hernia Surgery Risks
This type of operation is normally very safe. But like all surgeries, having your hernia removed comes with a number of possible complications. They include:
- Infection of the wound
- Blood clots: These can develop because you’re under anesthesia and don’t move for a long period of time.
- Pain: In most cases, the area will be sore as you heal. But some people develop chronic, long-lasting pain after surgery for a groin hernia, for example. Experts think the procedure may damage certain nerves. Laparoscopic surgery may cause less pain than an open procedure.
- Nerve damage: Your stitches or staples may press on a nerve. Or a nerve might get trapped during the surgery. If you feel sharp or tingling pain, tell your doctor. You may need another procedure.
- Recurrence: The hernia could come back after the surgery. Research shows that using mesh can reduce your risk of this happening by half.
Non-Surgical Hernia Treatments
Your physician may recommend that you wear a corset, binder, or truss. These supportive undergarments apply gentle pressure on the hernia and keep it in place. They may ease discomfort or pain. They’re used if you aren’t able to have surgery, or for temporary relief before your procedure.
Only use these garments under your doctor’s supervision. In some cases, they may make a hernia worse or hide the signs of incarceration or strangulation.