About inguinal hernia surgery all of the following are true, except:
Correct Answer: Surgery should not be done unless patient becomes symptomatic
Description: Surgery can be done even if the patient is asymptomatic.
Non-absorbable mesh is used for hernia surgery.
Hernia in children can be treated with herniotomy only. Inguinal floor reconstruction can be needed in children with large hernias.
Coming to option 'c' i.e. "Surgery should not be done unless patient becomes symptomatic"
Surgery can be done even in asymptomatic patients. Let's see this in a little detail as future questions can be asked with little twists in the statement.
The decision to repair an asymptomatic hernia or go for 'watchful waiting' has been a matter of many research studies.
Surgery Vs Watchful waiting:
It's agreed that the definitive treatment of all hernias, regardless of their origin or type, is surgical repair. Outcomes are generally excellent with minimal short-term morbidity and rapid return to presurgical health. This is true even in elderly individuals, especially with the use of local anesthesia.
These surgical outcomes combined with limited outcome data in patients who do not undergo surgery have led to recommendations to offer surgery to most patients with a groin hernia, regardless of symptoms. The risks of delayed surgery are primarily related to the risk of incarceration and strangulation, which are the only true medical indications for repair of hernias. However, it is not possible to identify with any degree of reliability which hernias are likely to incarcerate or strangulate versus those that will remain uncomplicated.
The other school of thought favoring Watchful waiting say that: While surgery is clearly indicated for most patients with significant symptoms related to a hernia, it may be reasonable to delay surgery in patients with inguinal hernia who have minimal or no symptoms.
Various studies comparing "watchful waiting" vs "immediate surgery in asymptomatic patients" have found no difference in the rate of hernia accidents and pain scores between the surgery and watchful waiting groups, although patients who had immediate surgery responded that their general health had improved at one year, compared to a perception of health decline in the 'watchful waiting' group.
These findings suggest that a strategy of watchful waiting rather than referral for surgery can be considered in patients with asymptomatic or minimally symptomatic inguinal hernia, as long as they are aware of the risk, albeit small, of hernia complications and understand the need for prompt medical attention should symptoms of these complications occur.
Although most authors agree that watchful waiting is a safe therapeutic option, some authors suggest elective surgery, rather than watchful waiting, for patients who are elderly, who have limited access to emergency care, or significant illness that would put them at greater risk for poor outcome after bowel strangulation.
Category:
Surgery
Get More
Subject Mock Tests
Practice with over 200,000 questions from various medical subjects and improve your knowledge.
Attempt a mock test nowMock Exam
Take an exam with 100 random questions selected from all subjects to test your knowledge.
Coming SoonGet More
Subject Mock Tests
Try practicing mock tests with over 200,000 questions from various medical subjects.
Attempt a mock test now