5. Risks and Benefits
The rationale for surgery is to reduce the symptoms caused by hernias, potential complications from surgery as hernias grow bigger and to remove the unpredictable risk of strangulation. However all options do carry some risk.
Hernias do tend to get larger over time and in this case subsequent surgery can be more difficult and associated with higher risk of complications. The risk of strangulation is unpredictable. Some studies have suggested that this may be significantly less than 1% per year whilst others have suggested that subsequent emergency surgery for strangulated hernias is associated with a high risk of complications and death.
Complications and outcomes following surgery appear to differ greatly between surgical centres. However in competent hands hernia surgery is a routine operation and significant complications only occur occasionally. The quoted risks below are taken from published studies, for our complication rate, please follow this link (to add link to hernia audit when completed)
- Bleeding – major bleeding rare; bruising 5-10%
- Infection – significant infection rare, superficial wound infection – 1-2%
- Hernia recurrence – highly variable, should be 1-2%
- Urinary retention -1-2%
- Serious injury to internal organs – this is rare
Each of the above should be in the order of 1-2% and studies suggest that in competent hands the risks are the same whether the surgery is undertaken laparoscopically or using an open technique.
- Bruising – can occur after any operation and probably occurs 5-10% of the time after hernia surgery
- Long term discomfort/numbness in the groin - Some patients experience either numbness or chronic discomfort in the groin. This seems to be more common following open hernia surgery, with some studies suggesting that the incidence may be as high as 40%! The evidence would suggest it is significantly lower following laparoscopic operations when the likelihood is probably 1-2%.
General Anaesthesia versus Local Anaesthesia
Laparoscopic surgery cannot be undertaken under local anaesthetic, which some patients prefer.