3 Surgical treatment
A hernia must always be operated on since the hernia opening will never close on its own. Furthermore, surgery should be performed as soon as possible to prevent the dangers posed by strangulation of portions of the intestines and/or omentum. There is no other treatment option. Even if under certain circumstances the hernial sac is repositioned in the abdominal cavity, it will be pushed forwards through the hernia opening once again the next time there is a rise in abdominal pressure, for example when coughing, thus expanding the latter. The use of conservative treatment methods, such as wearing a hernia truss (a belt-like device intended to keep abdominal structures in place within the abdominal cavity) have not only not proved very useful, but have even turned out to be harmful. On using a hernia truss, the abdominal muscles can retract, making the abdominal wall more unstable and thus increasing the risk of further hernias. Moreover, under certain circumstances serious injuries can be caused by the pressure exerted on the skin beneath the hernia truss.
Hernia operations are the most commonly conducted type of surgical procedures. Certain surgical techniques have proved useful whereby the surgeon repositions the hernia contents in the abdominal cavity, closes the hernia opening and stabilizes the tissue. Which surgical method is the most appropriate will depend on the nature and extent of the hernia as well as on the patient’s everyday demands and age. There are various methods to close hernia openings – for example merely suturing methods where sutures are used to treat and stabilize the hernia, or methods using a synthetic mesh. In principle, it is possible to perform the operation in a conventional open surgery method or by means of an endoscopic (also called laparoscopic or minimally invasive) technique.