Hernias occur when the abdomen organs, usually the intestines, break through the abdominal wall due to weaknesses in the abdominal muscles. Patient characteristics and the severity of the problem usually dictate the best course of treatment.
Watchful Waiting
In some instances, a hernia might be monitored for several years before any surgical repair is necessary. Generally, these hernias do not cause pain and there is no evidence that the protruding organs are strangulated. Sometimes these hernias can be pushed back inside manually and in the meantime, supportive garments can minimize additional protrusion of the organ. People who are very large and do not have a severe hernia might be advised to lose a significant amount of weight before a repair is done. Significant weight loss will make the surgery easier because laparoscopic surgery might be an option and weight loss can reduce the risk of complications or a repeated hernia.
Open Surgery
Although minimally invasive surgeries are preferred for hernia repair, there are instances when open surgery is necessary for repair. For example, a patient who is quite large with much of their weight centered around their abdomen would likely require an open procedure because the instruments in laparoscopic surgery may not be able to reach the hernia site. Depending on the severity of the hernia, the protruding organ might simply be pushed back into place or there may be the need to remove part of the organ if it has lost blood flow and has become necrotic. Once these issues are handled, surgeons can repair the abdominal wall. Typically, an inner and outer layer of mesh is placed at the weakened area of the abdominal wall to give it strength and reduce the chance of subsequent hernias.
Laparoscopic Surgery
Laparoscopic surgery is the preferred method of fixing hernias. Since the surgery requires a few small incisions to reach the site of the hernia, recovery is usually faster and there is less risk of infection at the surgical site when compared with open surgery. The process of hernia repair is much like open surgery, except it is done with laparoscopic instruments and a small camera inserted into the abdomen. With laparoscopic surgery, the defect in the abdominal wall is repaired and mesh is used to add additional support to the repair.
Hernias are fairly common conditions that do not always require immediate surgery. In many cases, a hernia that is not causing pain and is not damaging the internal organs can be monitored regularly before surgery is necessary. For more information, speak with a general surgeon today.
