Treatment of hernia20 Feb 2015
For an inguinal hernia, doctors’ views differ on whether elective surgery to repair it is necessary if it produces no symptoms and can be pushed back into the abdomen.
Some - the American College of Surgeons, for example - say an operation in these cases is not necessary and watchful waiting is sufficient.
Others - UK health authorities, for example - recommend surgical repair to remove the risk of later strangulation of the gut, when blood supply to the affected part gets cut off - which is an emergency indication for surgery. A routine operation is also less risky than an emergency one.
Surgical options depend on individual circumstances, including the location of the hernia, but there are broadly two types of surgical intervention:
- Open surgery
- Laparoscopic operation (’keyhole surgery’).
Open surgical repair closes the hernia using sutures, mesh, or both, and the surgical wound in the skin is closed with sutures, staples, or surgical glue.
Laparoscopic repair is used for repeat operations to avoid previous scars, and while usually more expensive, is less likely to cause complications such as infection.
For surgical repair of a hernia guided by a laparoscope, smaller incisions are enabled, offering a faster recovery from the operation.
The hernia is repaired in the same way as in open surgery but is guided by a small camera and a light introduced through a tube.5 Surgical instruments are introduced through a further small incision. The abdomen is inflated with gas to improve visualization and space and the whole operation is performed under general anesthetic.
The American College of Surgeons has produced a guide that gives detailed information about surgical repair of hernias, including the risks involved.
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