Do I Need Surgery for Hernia?

A hernia occurs when fatty tissue or an organ pushes through a weak place in the surrounding connective tissue or muscle wall. 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 often recommend surgery. But not every hernia needs immediate treatment. It depends on the size and symptoms.

A surgical hernia repair involves pushing the bulge back inside the body part that should contain it, and keeping it there.

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 and is a surgical emergency. Strangulated organs, usually your intestines, will die, and if not removed quickly, you can become seriously ill. 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.
  • 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.

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Open surgery: You will receive general anesthesia before having open surgery. 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 the size, type, and location of your hernia. 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.
  • 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.

WebMD Medical Reference Reviewed by Sabrina Felson, MD on March 21, 2019

Sources

SOURCES:

Robert Fitzgibbons, Jr., M.D., Chair, Department of Surgery, Creighton University.

National Institute of Diabetes and Digestive and Kidney Disease: “What Is an Inguinal Hernia?”

American College of Surgeons: “Groin Hernia Repair.”

Harvard Health Publications: “Hernia Repair.”

Mayo Clinic: “Inguinal Hernia,” “Hernia Truss: Can It Help an Inguinal Hernia?”

Cleveland Clinic: “Do You Need Hernia Surgery?”

Cochrane Library: “Laparoscopic Techniques Versus Open Techniques for Repair of a Hernia in the Groin.”

Ulster Medical Society: “Chronic Pain After Inguinal Hernia Repair.”

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