surgeons demonstrate the benefit of waiting under surveillance before the operation

It’s very original. This week, surgeons publish in the major journal of Lancet an article to promote waiting before operating on patients suffering from an inguinal hernia. Details from Géraldine Zamansky, journalist at Health Magazine on France 5.

franceinfo: This study concerns more specifically men with an inguinal hernia, which is very common?

And yes, when the muscles at the bottom of the abdomen relax a little over the years, they more easily allow a small part of the intestine to pass under the skin, at the groin level. This can take the form of a ball of very variable size. The risk is strangulated hernia, when the hole through which the intestine came out tightens and blocks it. There, we really need to operate.

But apart from this emergency, when is the right time? To answer this question, these Dutch surgeons offered 496 patients two options by drawing lots. Either immediate intervention or waiting under surveillance. Result, after 12 years of follow-up – which is very rare – a third of the volunteers in the second group still did not need the scalpel.

Okay, but the others, two out of three, were operated on?

Quite. Often within the first couple of years, if they had bothersome symptoms to begin with. But those who did not have one stayed away from the operating room 4 years longer on average. And above all, whatever the initial option, the quality of life is similar after 12 years. This is the whole point of this study: to prove that it is possible to take your time without danger. An additional argument for future consultations with Dr Jérôme Loriau.

This head of the digestive surgery department at Saint-Joseph Hospital in Paris explained to me that for him, the main criterion for the intervention is the level of discomfort and pain felt by the patient. Unless he identifies a threat of hernia strangulation, of course.

But why does he not prefer to operate from the outset to avoid this risk entirely?

Because, sorry to remind you of this somewhat worrying but essential information, every operation involves risks. Regardless of the expertise of the surgeon. Dr. Loriau, for example, reminded me that during the “tidying up” of the hernia, damage to a nerve is very rare, but possible. Sometimes with persistent pain.

The whole thing must therefore be discussed in consultation, to assess with each patient their famous benefit/risk balance. And be careful, if the study focused on inguinal hernia operations in men. This is not an oversight. This is because women often have different hernias which must be operated on quickly.

The study