NIS

Delaying Hernia Surgery

  • Is it safe to delay hernia surgery?
No, not entirely. We generally recommend that a patient have their hernia fixed as soon as it is practical. Below we detail the risks
  • Is there ever a good reason to delay surgery?
If you do not have insurance and you cannot afford to pay for surgery you may have no choice. But you should really explore all options. For children with hernias we admonish the parents to find a way. Give up something and get your child's hernia fixed. Adults can accept for themselves the responsibility and the consequences of not doing something that they know that they should do.
We usually do not recommend weight loss prior to hernia surgery. Delaying surgery for this reason usually only allows the hernia to grow larger and exposes the patient to the risk of strangulation.
Medical problems may be legitimate reason to delay surgery. This is in particular true for acute infections such as pneumonia and bladder infections which are expected to be cured with a short course of antibiotics. Heart problems may also mandate delay.
  • How long may surgery be delayed?
When we evaluate a patient and recommend surgery we customarily expect this surgery to be done within one month. Patients who ask to wait longer than this are given a caution. A request to wait six months or more will earn the patient a strong warning.
It is true that we have seen patients successfully evade surgery for decades. It is also true that we have seen patients die of a hernia that they were not even are aware that they had.
  • What are the risks of delaying hernia surgery?
Progression and strangulation are the two main consideration.
All hernias get larger over time. They never get smaller. This is called progression. A small hernia is easier to fix and the recovery is shorter compared to a large hernia.
Strangulation of a hernia is the complication of a hernia which may result in loss of life. We cannot assign a percentage over time risk estimate for this problem. Patients are individuals and applying a statistic to try to manage this risk is nothing but dangerous. Something else that makes it difficult to try to manage this risk is the fact that you will get no warning signs before it happens. One day you feel fine and the next you are in emergency surgery getting your hernia strangulation repaired.

A question that I am frequently asked is "What is risk of strangulation if I wait a few months?" This is a very difficult question to fairly and accurately answer. The best I can answer is with a question: Do you want something dangerous and unpredictable hanging over your head?

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