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Management of Abdominal Hernias pp 91–101Cite as

Principles in Hernia Surgery

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Abstract

Abdominal wall hernia surgery is no different from any other surgical procedure in that the rules of appropriate patient selection and preparation apply. The mortality from hernia surgery relates either to operating prior to optimization of the patient or to complications of the surgery itself. An analysis of the Scottish Audit of Surgical Mortality noted inadequate resuscitation, failure to use HDU, and inadequate perioperative monitoring as adverse factors contributing to death [1]. Most hernias never require emergency surgery, and 4 or 5 h of careful resuscitation may be beneficial in the most ill patients [2]. Analysis of the Swedish Hernia registry revealed a sevenfold increase if the surgery was performed as an emergency and a 20-fold increase if bowel resection was undertaken [3]. The same principles apply for elective hernia surgery: -fully assessment and optimization of the patient prior to embarking on surgery. An analysis of 175 patients with ages greater than 66 years, of whom 58 % were ASA III or higher, revealed that elective or urgent operation can be carried out with zero mortality, provided prompt diagnosis and management of primary systemic diseases are performed.

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Author information

Authors and Affiliations

  1. Department of Surgery, Royal Bournemouth Hospital, Dorset, UK

    David H. Bennett

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  1. David H. Bennett
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Correspondence to David H. Bennett .

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Editors and Affiliations

  1. , Department of Surgery, Peninsula College of Medicine & Dentistr, N/A, Plymouth, PL4 8AA, Devon, United Kingdom

    Andrew N. Kingsnorth

  2. , Surgeons Group of Baton Rouge, Our Lady of the Lake Physician Group, N/A, Baton Rouge, 70808, Louisiana, USA

    Karl A. LeBlanc

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Bennett, D.H. (2013). Principles in Hernia Surgery. In: Kingsnorth, A., LeBlanc, K. (eds) Management of Abdominal Hernias. Springer, London. https://doi.org/10.1007/978-1-84882-877-3_6

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  • DOI: https://doi.org/10.1007/978-1-84882-877-3_6

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