Not all hernias require immediate surgery, and I want to be honest about this because the fear of an unnecessary operation is one of the most common reasons patients delay consulting a surgeon when they feel a hernia. There is a legitimate role for watchful waiting in specific situations: minimally symptomatic inguinal hernias in older patients with significant heart, lung, or other medical comorbidities where the anaesthetic and surgical risk is meaningfully elevated may reasonably be observed if the hernia is not growing and not causing functional limitation. Small asymptomatic umbilical hernias with no symptoms and stable size are similarly candidates for clinical monitoring rather than immediate repair. However, these are the exceptions, not the rule. For the majority of patients, I recommend elective hernia repair for three interconnected reasons. First, hernias do not heal spontaneously. The weakness in the muscle wall that allows tissue to protrude does not close on its own, and most hernias enlarge progressively over time. Second, the risk of a hernia becoming complicated, either by trapping the protruding tissue (incarceration) or cutting off its blood supply (strangulation), is real and cannot be predicted in advance. Strangulation transforms what would have been a day-case laparoscopic repair into a complex emergency operation with significantly higher morbidity. Third, elective laparoscopic hernia repair at Aster CMI Hospital, Bengaluru is very well tolerated: most patients go home the same day, are active within days, and return to desk work within a week. The risk of watchful waiting is that a straightforward operation becomes a complicated emergency. For most patients with hernias, earlier elective repair is the right decision.
Written by Dr. Mahesh Channappa, MBBS, MS (General Surgery), MBA (Healthcare Management), FAIS, FIAGES, FALS (Fellowship in Advanced Laparoscopic Surgery), FMBS (Fellowship in Bariatric and Metabolic Surgery), Da Vinci Robotic Surgery Training, UK NHS 3-Year Structured Surgical Training, Lead Consultant, General and Gastrointestinal Surgery, Bariatric Surgery, Minimally Invasive (Laparoscopic/Robotic) Surgery and Laser Proctology, Aster CMI Hospital, 43/2, NH 7, New Airport Road, Sahakar Nagar, Sanjeevini Nagar, Bengaluru, Karnataka 560092 (Monday to Saturday, 9:00 AM to 4:00 PM). Also at Vikyath Diagnostics Center, Sahakarnagar Main Road, G Block, Sahakar Nagar, Bengaluru 560092 (Monday to Saturday, 6:30 PM to 7:30 PM). 26 years. Phone: +91 9620354889 / +91 9844816622.
