Surgery is the most effective way of treating a hernia, but do all hernias require surgery? If you have been diagnosed with a hernia, the next step is exploring treatment options and consulting with a surgeon. Hernia repair with an experienced laparoscopic surgeonis the most comprehensive way to address symptoms and treat the problem. Read on to discover the different types of hernias and what size hernia needs surgery.
Not all hernias require surgery immediately, especially when they are asymptomatic. However, because hernias don’t recover or resolve on their own, surgery is recommended to avoid the hernia deteriorating. The decision to proceed with a hernia surgery is based on several factors your surgeon will consider during a consultation.
Hernias left untreated can risk serious damage to the rest of the body or even become life-threatening. When the risk of strangulation or obstruction is greater, your surgeon is more likely to recommend hernia surgery.
Strangulation refers to the bloody supply to the affected area of the hernia being constricted by pressure at the abdominal wall. Strangulation can escalate to ischemia, which precedes gangrene. Obstruction is a medical emergency that requires immediate surgical repair due to the bowels being obstructed. Common symptoms are crampy pain in the abdomen, vomiting, and obstipation (severe constipation).
Symptomatic hernias associated with ongoing pain, nausea, vomiting, and obstipation require urgent surgical attention. Although hernias can present themselves as swelling, they can cause greater discomfort while standing, straining, or other forms of physical exertion that limit the physical activity you can participate in. Your surgeon is more likely to recommend surgery in these scenarios where a hernia is symptomatic or reducing your quality of life.
The size of the hernia will also influence the level of discomfort it causes. Small hernias may cause only mild discomfort or minimal symptoms, making them easier to manage. However, larger hernias often apply more pressure to surrounding tissues and nerves, leading to increased pain and a higher risk of complications such as obstruction or strangulation of the herniated tissue. In cases where larger hernias lead to persistent symptoms or impact daily life, surgical repair may be strongly advised.
Hernias are generally classified by where they are located on the body. Regardless of what type of hernia you are diagnosed with, all hernias may require surgery.
Inguinal hernia: These hernias are located in the groin and are most commonly diagnosed in males. They occur when parts of the intestine or other intra-abdominal contents protrude out from a weak section of the fascia.
Femoral hernia: Femoral hernias are also found in the groin and are more common in females, though they are rare overall. These hernias come with a higher risk of strangulation due to the femoral canal being narrow.
Incisional hernia: An incisional hernia is a type of post-operative complication at or near the surgery site. It occurs when an abdominal wound does not heal completely following surgery and is more likely to be found in obese patients, those with a wound infection, smokers, or those who have undergone multiple abdominal operations. Sometimes, more than one incisional hernia may be present, which requires imaging to identify.
There are two medical approaches to hernia surgery. Each treatment option has its appropriate use, which a surgeon can explain in further detail for you.
Hernia treatment has traditionally been performed as open surgery, and in some cases, this approach is still recommended. Your surgeon may suggest open hernia surgery if you’re at high risk for general anaesthesia, which is typically required for laparoscopic procedures. Open surgery can be performed using local anaesthesia instead, making it suitable for patients who cannot undergo general anaesthesia.
Open surgery may also be advised for patients who are significantly overweight, have experienced hernia recurrence after a laparoscopic procedure, or have undergone extensive abdominal surgeries in the past.
In an open procedure, the surgeon makes an incision about 7–10 cm long, dissects the hernia sac, and returns the hernia to its proper place within the abdominal cavity. The abdominal defect is then reinforced with either mesh or sutures to prevent recurrence.
Laparoscopic surgery is a newer method of hernia repair that has become the preferred approach due to its less invasive nature. This technique often allows patients to return to work and resume regular activities sooner, with potentially less discomfort or pain. Laparoscopic repair is also recommended for cases of hernia recurrence after a previous open surgery or when inguinal hernias are present on both sides (bilateral hernias).
The procedure involves small incisions, typically 5 to 10 mm, and uses advanced technology, allowing surgeons to view the area with a telescope for precise repair.
Surgery can seem like a big decision, but with today’s medical technology, it is a regular part of keeping us safe and healthy, especially when it comes to the different types of hernia that our bodies may develop. A hernia diagnosis doesn’t have to be stressful. An experienced surgeon who puts patient care first can guide you through what a hernia is and safely repair it if necessary.
Book a consultation with Dr Michael Chu today to explore whether surgical treatment is the best option for treating your hernia.