A hernia occurs when an organ or other structure pushes through a weak area in tissue or muscle. Hernias can bulge into the chest, thigh, groin, or belly button and cause a visible lump. Some hernias can cause significant pain. Organs that get trapped at the hernia site are in danger of strangulation—a surgical emergency.
The goal of hernia surgery is to return the organ or structure to its proper place and fix the weak area of muscle or tissue.
Are There Other Treatment Options?
For small hernias that aren’t causing problems, doctors may recommend watchful waiting. Studies comparing watchful waiting to surgical repair of inguinal hernias show that watchful waiting is a viable option. However, most hernias require surgery to repair them.
Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on surgery.
When to Consider Hernia Repair
You may want to consider surgery if the hernia is large, and pain and discomfort are diminishing your quality of life. Your doctor may decide that you are a good candidate for hernia surgery if the hernia is:
Large
Growing
Causing pain
Causing internal structures to become trapped outside the abdominal wall—called an incarcerated hernia because it can cut off blood supply to the hernia—making it a strangulated hernia. This is an emergency situation and you will need to have surgery right away.
Some surgeons practice a standard of care of repairing hernias, even if the patient does not fall into one of these categories. The goal is to avoid potential complications of hernias, such as incarceration and strangulation. But nonsurgical, watchful waiting is an equally valid choice if the hernia is not causing any immediate problems. Whether or not to repair a hernia is a shared decision between you and your doctor. Shared decision making will allow both you and your surgeon to fully weigh the benefit and risks of surgery vs. watchful waiting.
If you decide on surgery, ask your surgeon if you are a good candidate for minimally invasive hernia repair surgery. It can involve a faster recovery and less pain than open surgery.
Who Is NOT a Good Candidate for Hernia Repair?
You may not be a good candidate if:
You have a high risk of surgical complications.
You are elderly (hernia repair studies suggest elderly as older than 75 years of age) and your hernia is not causing pain or discomfort. The risks of surgery may outweigh the benefit of hernia repair.
You have a terminal disease and your hernia is not trapped outside the abdominal wall.
You have a severe illness or infection.
What to Expect
A surgeon repairs a hernia with either a large incision (open surgery) or laparoscopic surgery with small, button hole-sized incisions. You may have general or regional anesthesia, and you may need to stay in the hospital, depending on the type of surgery. Length of stays also differ between hospitals.
Recovery after hernia surgery is a gradual process. You may need help with household, work, and other daily activities. Gradually, you’ll feel like yourself again and resume daily activities without pain. Full recovery times range from 2 to 6 weeks.
Hernia surgery will not prevent hernias from coming back. You can make changes in your everyday life that may help prevent or delay a hernia from coming back. This includes exercises to strengthen your muscles, maintaining a healthy weight, and avoiding straining.
