Hernia – Decision making – Watchful waiting vs Surgery

A hernia which is small, causing no pain may be observed. This option of no surgery in hernia is termed as watchful waiting. This option can be offered to a patient who has been seen by a hernia specialist. The patient has explained about the hernia and its complications. The need for surgery and complications of hernia in long term need to be understood clearly by the patient. During this no hernia surgery period, a patient is taught how to reduce a hernia swelling. This helps tackle an emergency when a hernia swelling becomes irreducible. Surgery could be delayed for months or years. A regular follow up with the hernia surgeon is advisable. This holds true more for adults than for children.

Since hernia is a mechanical defect, it requires a mechanical cure. It cannot go away with medicines. The use of a truss or corset is not recommended as they could do more harm than good. A wrongly worn truss can compress the hernia causing more harm than good.

The complications of hernia are irreducibility. When a hernia does not reduce spontaneously, it is termed as irreducible. A hernia specialist may try to gently reduce the hernia to tide over the emergency.

When a hernia is irreducible and even the doctor is unable to reduce it, an emergency surgery may be needed. During the waiting period, one can try to reduce weight to prevent complications after surgery.