Category Archives: Hernia Surgery
Hernia mesh can be a touchy subject for some. To be sure, there has been some controversy over the use of hernia mesh, even though it represents one of the biggest advances in hernia repair technology. In fact, mesh makes for a much more reliable hernia closure and longer-term repair than traditional tension repairs, which typically have a far higher rate of recurrence. As a result, most hernias today are repaired with mesh.
With that said, there’s still a lot to discuss about hernia mesh, and in this article, we want to separate the truths from the myths.
You might be researching hernia surgery, or you may have recently had it and you’re wondering what are the chances that the procedure fails due to recurrence. Recurrence of a hernia means the reemergence of the hernia after it has been repaired surgically. Naturally, our patients are interested to know if their hernia can recur and how it can be prevented.
The short answer is yes, a hernia can come back, but it’s not something to actively worry about. Modern hernia surgery has reduced the recurrence rate to somewhere between 1% and 3%, down from 15% or even more just a few decades ago. But, in order to assess the risk of developing a recurrent hernia, we have to understand how to prevent one.
Deciding whether to repair a hernia in patients of advanced age requires a back-and-forth discussion with your surgeon as well as a thorough examination of the particular circumstances involved. Until recently, the belief was that a patient gets older, hernia repair becomes less necessary and beneficial. To some degree, this still remains true for a couple of reasons:
- First, older patients tend to have weaker abdominal muscles, which reduces the likelihood of incarceration or strangulation. These are the two biggest considerations when deciding whether or not to have a hernia surgery.
- Second, older patients typically have a harder time recovering from a surgical procedure and often have a higher risk profile that younger patients, due to their age.
Hernias can occur at any age and are due to a number of factors. However, as we age and the muscle tissue in our bodies begins to degrade, we are more likely to develop a hernia. While having hernia surgery is typically recommended for young, otherwise healthy patients, the decision whether to have hernia surgery becomes less clear as a patient gets older. This is for a number of important reasons, some of which will be discussed here.
Hernias do not always present with obvious signs or symptoms and many patients will live for decades, or even their entire lives not knowing they have a hernia. Because of the relatively low risk of strangulation, we do not actively screen for asymptomatic hernias and only consider hernia surgery once they become symptomatic.
However, symptomatic hernia may cause interference with lifestyle pursuits and this is the best indication for corrective surgery. Interestingly, the relationship between the size of the hernia and the pain that it causes is not linear. In other words, small hernias may be very painful while large hernias may not be. So, whether or not a patient should have surgery is more a result of the kind of hernia and its symptoms versus its size.