InHealth: Should I have my hernia repaired?

By Jonathan Yunis, MD, FACS
April 2021

What is a hernia?

A hernia is a defect or hole in the muscular abdominal wall that allows internal organs or fat to pass through it toward the overlying skin. The most common hernias occur in the groin (inguinal and femoral hernia) and in the belly button (umbilical hernia). Others (ventral incisional hernias) occur in areas of previous surgical incisions in the abdominal wall.

When a hernia occurs, one may notice a protrusion or bulge under the skin of the abdomen.  The swelling or bulge can be painless, uncomfortable, or very painful. In some cases, the obvious bulge develops slowly over time. 

Who gets a hernia?

Most hernias occur because of a genetic predisposition.  Repetitive heavy lifting or other forms of exertion are likely to cause the hernia to occur earlier in your life.  Ventral hernias from an abdominal surgical incision will occur in 20% of all abdominal operations.  The risk for ventral incisional hernia development Is Increased by smoking, diabetes, obesity, and surgical wound infections.

When should you consider hernia repair?

While most hernias are painless, if your hernia is causing intermittent discomfort or pain, then surgical repair is the solution to eradicate these symptoms. Hernias are often disfiguring and an experienced hernia specialist often offers an enhanced cosmetic outcome.

While many hernias can remain unchanged over time, most hernias tend to get larger.  Hernia enlargement over time can lead to a much bigger operation with a more difficult recovery.  Smaller hernias are often amenable to outpatient surgery and with recovery that usually will not require prescription pain medicine.

In some cases, hernia repair is necessary to prevent a medical emergency known as incarceration or strangulation. Incarceration of a hernia is when the intestine is trapped in the hernia defect. This can result in obstruction of the intestine causing abdominal pain and vomiting. After a hernia incarcerates, it can strangle the intestine contained within the hernia.  This compromises the blood flow to the intestine and if surgery is not performed to relieve this, overwhelming sepsis and even death is a possibility.

How can I get the best outcome for hernia repair?

Seek treatment by an experienced hernia specialist whose practice is solely dedicated to hernia repair. If you have a hernia, you have options. Surgical options include conventional open surgery, laparoscopic surgery, and robotic surgery. Most repairs utilize mesh in order to reduce the risk of hernia recurrence. Some repairs can be performed without the use of mesh. There are many different types of mesh and it is generally safe when implanted by an experienced surgeon. 

If you choose hernia repair, the risk should be significantly lower than the risk of leaving it untreated. While this seems obvious, historically 1 in 4 people who undergo hernia surgery are unhappy due to problems with chronic pain, infection, or recurrence. These complications are clearly avoidable.

All hernias and the people that develop them are unique.  There is no standard approach to hernia repair.  Careful analysis of each person’s lifestyle and needs along with the location and size of the hernia are necessary to formulate a proper solution. A hernia specialist will help you make the best decision. 

Center for Hernia Repair
1435 S Osprey Ave #201, Sarasota, FL 34239
941.953.5917  •  www.centerforherniarepair.com