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When is hernia surgery needed?

A closeup of someone's lower torso with their hands cradling their stomach.

Some hernias can be managed for a while without surgery.

If you notice a bulge in your lower abdomen that wasn't there before, it could be a hernia. And that's a good reason to call your doctor, according to the National Institutes of Health. Hernias are very common, and most aren't dangerous. But they can sometimes be a medical emergency. So it's best to be checked out.

What is a hernia?

A hernia happens when part of the intestine pushes through a weak spot in the abdominal wall and forms a lump or bulge below the skin. You might spot the bulge when you stand or cough.

You can be born with a hernia, but most often, the weakness develops over time. Most hernias are in the lower abdomen or groin. But they can develop in other areas, too, such as inside the thigh, the belly button or along a previous surgery scar.

How is a hernia treated?

If you have a hernia, surgery is the only way to repair it. But you may not need to right away. If the hernia is small and can be pushed back into your abdomen, your doctor may suggest watchful waiting rather than surgery. Instead, you'd get regular checkups to see if the hernia gets larger or starts to cause pain or other trouble. Only then would you move ahead with surgery.

In the meantime, you can help keep the hernia from getting worse by avoiding things that put pressure or strain on the abdomen, such as heavy lifting, constipation or weight gain.

When is it time for surgery?

Your doctor may recommend surgery if your hernia is large, painful or trapped. A trapped hernia is when the bulge won't go back into the abdomen. This can be very serious because it can cut off the blood supply to part of the intestine. That's called a strangulated hernia. It can cause intestinal tissue to die—and may even be life-threatening.

This is why it's especially important to see your doctor right away if you have a hernia along with:

  • Severe, sudden or persistent pain in the belly or groin.
  • Nausea or vomiting.
  • Tenderness or skin redness at the site of the bulge.

Hernia surgery options

Fortunately, hernia surgery is one of the most common operations in the U.S., and it has a high success rate. Surgeons usually repair the weakened area in one of two ways:

  • Through a large, open incision. This is usually done if tissue or a piece of the intestine needs to be removed.
  • Through several small incisions with a tiny video camera to see inside the body and small instruments to make the repair. This is called laparoscopy.

The surgeon will often place a mesh material over the repair. The mesh acts like a patch. It reinforces the weakened muscle wall, which may help keep some hernias from coming back again.

After surgery

If you have hernia surgery, you will probably go home the same day or the next day.

How long it takes to recover can depend on both the type of hernia and the type of surgery you had. For example, if you had laparoscopy, you may be able to return to work and other routine activities in about a week. It might take longer to recover from open surgery.

While you're healing, be sure to follow your doctor's advice, including when it comes to activities like lifting.

And if you smoke, you should do your best to quit. Smoking may make a repaired hernia more likely to return again.

Want to learn more about hernias? Take a quick quiz.

Reviewed 8/14/2023

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