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.
There are, however, reasons why older patients can and should undergo surgery. Of course, these considerations must be discussed during consultation with a specialized hernia surgeon such as those at MASJax:
- Some hernias, as they get larger, begin to affect quality-of-life. This can manifest as pain or discomfort in the stomach or groin area and very large hernias can be visible through clothing and cause embarrassment or anxiety. In cases where the impediment to one’s normal lifestyle becomes overwhelming, and patient is a reasonably good candidate for surgery, an operation may be called for.
- Even in advanced age, some hernias have a greater chance of strangulating intestinal tissue. This is particularly true for women and femoral hernias – those that appear in the upper thigh. A strangulated hernia becomes an emergency, which is even riskier for a patient of advanced age. Strangulated hernias are more complex to repair and may require surgery on diseased intestinal tissue as well.
- Hernias are progressive and tend to get larger over time, and when left unrepaired. If a large hernia ultimately needs repair, this is a more complex procedure than handling it sooner, when the hernia is smaller.
As with any patient, most hernia repairs can be scheduled in advance. Typically, we have the option to treat or improve any risk factors, especially in older patients, by putting together a multidisciplinary team to handle modifiable health risks before surgery. While there is greater surgical risk in older patients, advances in minimally invasive technique and technology have reduced the overall risks of surgery tremendously.
Most importantly, patients should consider a hernia specialist for their procedure – that is a surgeon that has performed hundreds if not thousands of hernia procedures over their career and one for whom hernia surgery is a focus procedure. If you or a family member of advanced age has a symptomatic hernia, schedule a consultation with one of our doctors who can offer perspective as to whether the particular case requires surgery.