Should I have surgery for my hernia?

[dianajune]

I have a history of abdominal surgeries over the years, mostly for female problems.  The most invasive list of operations I've had are as follows:

Total abdominal hysterectomy in '04 because of a borderline ovarian cancer.  No chemo or radiation was needed and the prognosis is excellent.  I'm no longer seeing my oncologist.

Strangulated hernia and small bowel resection in '09.  About 10cm of my small intestine was removed and the hernia was repaired.  I had an infected seroma after surgery that took a couple of months to clear up.

Incarcerated hernia in October of 2011.  They thought I had a perforated colon so I was rushed into surgery that evening.  They found it was not perforated but incarcerated.  The repair was made, and many adhesions were removed.  My appendix was taken out because they were in there anyway.  A couple of months after surgery I went back to my doctor, thinking I had another hernia because my left lower abdomen was much larger than the other side.  The surgeon checked and said he  believed the contents of my abdomen shifted to one side.

After last year's surgery I was told I have diastasis recti.  Both of my previous hernias are on the left alongside my hysterectomy scar.  I believe both were called "ventral."  

Yesterday I went to the ER because my stomach seemed to be changing shape rapidly, and given my medical history that scared me.  The did a ct scan and said I have another hernia and it's too large to become incarcerated or strangulated.  However, they said that about my first hernia.  Several months after this it was strangulated.  Prior to discharge last night, they didn't tell me exactly how large the hernia was or exactly where it was located.  It is probably in the same area, and I'm guessing it's larger than the other two I had.  I was too upset about ending up in the hospital again to ask detailed questions.

I was told to call my surgeon (from last year) tomorrow and let him know I was there.  I spoke with him in the past about having more surgery (in case of recurrence) and was told I should lose weight first.  I'm 5'4 and weigh about 360-370.  At my heaviest I was well over 450.  It's a wonder I didn't have hernias when I weighed more all those years ago.  

I would prefer to lose weight first as I know it would reduce the risks involved, but losing weight (esp. with all that's happened to me) is rather difficult.  It seems to me that surgery for someone like me would be less risky if it's done on an elective basis, rather than in an emergency.

I was considering weight loss surgery before this happened, and I would assume this would have to be put off.  Could both be done at the same time?

I hate how I look.  My stomach looks deformed and I'm tired of all the stares I get from people.  It looks like I'm pregnant, but only on one side.  The left lower abdomen hangs lower than the right.  It seems as though the more the left sags, the more the right side goes up.  

Should I insist on surgery?  I would appreciate any advice anyone will give me.  Thank you.

[Clyde123]

My dr told me to lose weight and sent me home...no further visit s or recommendations were given....this seems odd....I'm about 60 lbs over weight....I know I need to lose....but shouldn't a hernia be removed regardless

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Any hernia needs to be surgically repaired to prevent complications like strangulation. The surgery is best performed as an elective surgery with all the adequate precautions, to prevent recurrence. So, as you wait for the surgery try to lose weight and if a diabetic, see that it is adequately controlled. But if you develop pain or redness or any signs of inflammation, please consult your doctor immediately. And the cosmetic repair of the abdomen could also be done with the hernia repair. But please discuss the various options with your doctor prior to surgery.

Hope this helped and do keep us posted.