Reply To: Surgery VS Watchful Waiting

[ajm222]

quote drkang:

Real watchful waiting should have strict conditions.
That is, it should be carried out under the condition that operation would be performed if the size increases over certain level, some pain appears, the frequency of pain increases, or other discomfort occurs and so on.
But many people are just waiting until the condition becomes very serious.
It is not ‘watchful waiting’ but just ‘neglecting’

As you know, herniated bowel or contents could be incarcerated/strangulated though it happens rarely.
But that is not the only problem.
The bigger the hernia is, the more difficult the repair is.
And the recurrence and complication after repair might also be increased.

So I think the sooner the better.
I personally recommend you to get hernia repaired if it is bigger than a cherry even though it doesn’t hurt at all.

I understand the possible mesh complication makes many people to hesitate.
And I know it’s difficult to find a surgeon who does tissue repair properly with low recurrence and less complication.
That is a pitiful dillema.

But I don’t think the so-called ‘hidden hernia’ should be repaired.
‘Hidden hernia’ is not a real hernia as dragon is not a real animal.
I think hidden hernia issue appeared after the inguinal hernia began to be repaired laparoscopically, because laparoscopically the operative procedures for real hernia and so called ‘hidden hernia’ are the same.
Actually that for hidden hernia(in other word, absence of real hernia)) is much more simple.
They just put the large mesh around inguinal area.

I hope that everyone would be able to have a hernia operation without worrying about it soon.

This is good info, thanks. Living in the US, and being somewhat restricted by the way insurance works within each state, most of us are at the mercy of the fact that 99% of hernia repairs seem to be done with mesh. And those that aren’t are probably performed by surgeons who only do a handful of pure tissue repairs a year and only in certain limited circumstances. So it’s basically a matter of when to get the mesh repair. Especially when you have to place a certain amount of trust in your doctors/surgeons and they all say that mesh is still the gold standard and the way to go. That’s what I am trying to decide myself now. I have a small little lump and feel like I should just get it fixed rather than simply wait for it to get worse. It isn’t large and it isn’t painful. But I have no doubt it will get to that point, eventually. I did read that it doesn’t make much difference in terms of success of surgery if you wait, unless it gets quite a bit larger. Maybe because mesh they use covers a large area anyway. I figure I can wait a few weeks or a few months. But I don’t like the idea of waiting longer, even if it isn’t painful. I’m already limiting myself greatly for fear of making things worse. I don’t like living that way. But I also don’t want any chronic pain at all from a surgery that doesn’t go perfectly. As you say, it’s a dilemma.