Reply To: Surgery VS Watchful Waiting

[Retained ForeignBodies causing pain or Chronic pain from Hernia?]

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.

Dear Dr. Kang,

I have a few questions regarding your comments on “so-called hidden hernias”:

Do you believe that hidden hernias are the first stages of a ‘real’ hernia? Or are they something else entirely?

I’ve had groin pain for 4 years but no visible or palpable bulge. Two years ago, an ultrasound revealed a small, 6mm indirect inguinal hernia. Is it your opinion that it should not be repaired? If so, is this because open, non-mesh surgery is not possible for hidden hernias – and that you don’t recommend laparoscopic repair with mesh? Or do you believe my pain is likely caused by something else?

Also, do you believe that this hernia will inevitably grow bigger and that a bulge will eventually appear? If so, would it not be better to get it repaired while it is small – particularly as it is symptomatic?

Thank you.