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Hernia Evaluation and Management
If you were just told that you have a hernia, then you probably have a few questions that need to be answered. First off, what exactly is a hernia? A hernia caused when there is a weakening in the abdominal wall creating a defect or “hole” that allows the intestines or other contents of your abdomen to protrude out, creating the bump that you feel. This sounds scary but there are many types of hernia and degrees of severity.
The biggest factor that will determine the next step is whether you have symptoms or not. If you have symptoms of pain, nausea, vomiting or if the bump will not go back in, then you need to see a general surgeon in the office or emergency room. If you occasionally have pain that comes and goes, you can be seen in the office. Most of my hernia patients are seen in the office for evaluation.
You are probably wondering what to expect at this upcoming visit. This is where you get to tell your surgeon how the symptoms present and how long you have had them. Sometimes they can be related to lifting something too heavy at one point, or chronic heavy lifting. There are many other causes which you and your surgeon will discuss. A physical exam will also take place to give the surgeon a chance to evaluate the size and type of hernia repair you will need. Sometimes the hernia best appears when you are standing up, so your exam may be standing or lying flat depending on location.
What are you options at this point? You will get the options of either surgery or no surgery. This depends on your surgeon’s evaluation of your existing risks. They will decide if surgery is safe for you or if a conservative route is more beneficial. The alternative to surgery would be nonoperative observational period. Observation allows you to better optimize your health or weight, if that is an option. Some people may not have any further issues with the hernia, but again this is different for everyone.
If you fall in the surgery option, then you will want to discuss with your surgeon the best repair for you. There are many options for repair including an open, laparoscopic or robotic repair, with or without a mesh. The type of repair you will have depends on your hernia and surgeon’s preference, comfort and experience. They will also talk to you about the post-operative expectations as well. It is very important that you ask all your questions at that time.
I have seen that patients do much better in the post-operative course when their expectations are addressed. Explaining the any type of discomfort, swelling, and even possible complications in detail allows patients to be mentally prepared and get through the healing phase much better and faster. So, if you are told you have a hernia this article should give you some guidelines of what to expect and possible questions to have addressed in your office visit.