What are the treatment approaches for adults with very large chronic abdominal inguinal hernias?

Updated: Jul 23, 2019
  • Author: Assar A Rather, MBBS, MD, FACS; Chief Editor: John Geibel, MD, DSc, MSc, AGAF  more...
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Answer

Adults with very large chronic hernias should be admitted postoperatively because of the combination of ileus from extensive manipulation and loss of domain with the attendant problems of increased pressure on the diaphragm, vena cava, kidneys, and hernia closure. Adults who present with bilateral hernias without the need for formal reconstruction can undergo simultaneous repair; more complex procedures require the repairs to be separated by at least 1 month.

Local anesthesia is sufficient for most repairs in adults; however, prolonged procedures, repair of hernias with a large intraperitoneal component, including laparoscopy, and repair of recurrent hernias are best managed with spinal, epidural, or general anesthesia.


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