Treatment options

 

There is always the option to do nothing. Doing nothing leaves things as they are, and obviously removes any risk of surgery -

BUT..

  • The hernia will almost certainly enlarge with time, becoming more of a nuisance to you
  • Any symptoms, such as discomfort will also worsen, affecting your quality of life
  • Delaying surgical repair and allowing the hernia to enlarge significantly is likely to make later operation more complicated
  • There is always the (rare but real – perhaps 2-5%) possibility of strangulation – where the bowel becomes trapped in the hernia and loses its blood supply – requiring emergency surgery.

Some doctors advise, and some patients use, a truss. A kind of a belt with a piece of padding to hold the hernia in. Not recommended.

In the majority of cases surgical repair is better option. Nowadays mesh is almost universally used.

The two main surgical options are

  • Open repair – local anaesthetic or general anaesthetic
  • Laparoscopic (‘keyhole’) repair - general anaesthetic only

 

Surgery 

This section is fairly technical. However, my experience from talking to patients is that they can understand the operations if they are explained properly. Most people are not that familiar with our anatomy, how we are put together and what we look like inside. The explanations are made worse with the use of technical anatomical language.

With my explanations I tend to use a lot of analogies – examples from every day life – and aim to use everyday understandable language, and I hope that works for you.

Surgeons, operations and mesh

Just before I start I want to say a word about surgeons, operations and mesh.
There seems to be an assumption that you are comparing operations – like comparing similar items in a supermarket.

But you are really comparing the combination of operation and surgeon – and the balance is certainly much more with the importance of the surgeon. The actual mesh is probably the least important part of the whole process.

‘I really don’t mind what wallpaper my decorator uses – if he is experienced I trust him to use the most appropriate one’.

And staying with this analogy - I have had a number of patients who work as kitchen fitters – they all tell me that the make of kitchen is not nearly as important as who fits it and how it is fitted. I hope that makes sense.

So choosing your operation, or even your mesh is not really the best way to go. Find your surgeon, make sure he knows how to do the operation, and trust him to do the best job.

Specialist hernia surgeons and experts

Someone recently asked me – about specialist hernia surgeons.

It’s not really a question of specialising – it’s a question of expertise. How expert and skilled is that person at repairing a hernia. How much real interest do they have in this area of surgery

Some of the best hernia surgeons I know – starting with my colleagues – the board of the British Hernia Society – do other surgery (at which they are technically expert) – and they are all real hernia ‘experts’.