{"id":14923,"date":"2025-04-17T15:12:43","date_gmt":"2025-04-17T15:12:43","guid":{"rendered":"https:\/\/venaziel.de\/phlebology-knowledge-center\/when-does-a-hernia-need-to-be-operated-on\/"},"modified":"2026-04-21T09:34:38","modified_gmt":"2026-04-21T09:34:38","slug":"wann-leistenbruch-operiert-werden","status":"publish","type":"page","link":"https:\/\/venaziel.de\/en\/hernien-wissenszentrum\/wann-leistenbruch-operiert-werden\/","title":{"rendered":"When does a hernia need to be operated on?"},"content":{"rendered":"<h2><b>What is a hernia?<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">An inguinal hernia occurs when abdominal contents push through a weak spot in the abdominal wall. This weak spot is in the area of the inguinal canal. This hernial orifice allows tissue (usually fat or intestinal parts) to protrude from the abdominal cavity to the outside.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Typically, the hernia occurs with increased pressure in the abdomen, such as when lifting heavy loads, straining, coughing, or sneezing. The most common causes are:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Congenital connective tissue weakness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Physical overload<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Chronic cough or constipation<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Previous operations or scars<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\"> <\/span><\/p>\n<h2><b>Symptoms of a hernia<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">The symptoms of an inguinal hernia are often non-specific. Typical symptoms include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Visible or palpable protrusion in the groin area<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pulling, pressure or burning when coughing, sneezing or carrying<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pain that can radiate to the testicles or thighs<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Regression of the protrusion when lying down<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">For <\/span><b>women<\/b><span style=\"font-weight: 400;\"> an inguinal hernia often manifests itself more diffusely and is often recognized later.<\/span><\/p>\n<p>&nbsp;<\/p>\n<h2><b>When is surgery necessary for an inguinal hernia?<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">The indication for surgery results from several factors:<\/span><\/p>\n<h3><b>Immediate surgery required for:<\/b><\/h3>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Incarcerated hernia (incarceration): The contents of the hernia can no longer be pushed back. There is an acute risk of bowel obstruction.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Severe pain at rest, nausea, vomiting, stool retention<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fever, inflammation or signs of peritonitis<\/span><\/li>\n<\/ul>\n<h3><b>Early surgery recommended for:<\/b><\/h3>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Increasing fracture size<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Complaints during exercise<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Physically active patients, athletes or younger patients<\/span><\/li>\n<\/ul>\n<h3><b>Observation possible with:<\/b><\/h3>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Symptom-free, small hernias<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Elderly or multimorbid patients for whom the surgical risk predominates<\/span><\/li>\n<\/ul>\n<h2><b>Risks of an untreated hernia<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">A hernia does not heal <\/span><b>not spontaneously<\/b><span style=\"font-weight: 400;\">. Without surgical treatment, there is a risk of serious complications:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Incarceration<\/b><span style=\"font-weight: 400;\"> (incarceration of bowel or fatty tissue): Emergency!<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Strangulation<\/b><span style=\"font-weight: 400;\"> (intestine is cut off from the blood supply): Danger to life!<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Chronic pain<\/b><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Increase in size of the fracture<\/b><span style=\"font-weight: 400;\">Difficult later operation<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2><b>Modern surgical methods<\/b><\/h2>\n<h3 style=\"padding-left: 40px;\"><b>1. the TAPP method (transabdominal preperitoneal meshplasty)<\/b><\/h3>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Minimally invasive (keyhole technique)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Implantation of a mesh behind the hernial orifice<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Particularly suitable for bilateral or recurrent hernias<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Can be performed on an outpatient basis, low complication rate<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3 style=\"padding-left: 40px;\"><b>2nd TEP method (total extraperitoneal meshplasty)<\/b><\/h3>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Like TAPP, but without opening the abdominal cavity<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Very gentle, low risk of internal injuries<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3 style=\"padding-left: 40px;\"><b>3. the Lichtenstein method (open surgery)<\/b><\/h3>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Standard method for unilateral fracture<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Mesh fixation through groin cut<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Good long-term results<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3 style=\"padding-left: 40px;\"><b>4. robot-assisted hernia surgery (e.g. with da Vinci\u00ae)<\/b><\/h3>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">High-precision technology for complex cases<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Not yet necessary across the board, but useful for special indications<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2><b>Healing process &amp; aftercare<\/b><\/h2>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Outpatient surgery<\/b><span style=\"font-weight: 400;\"> usually possible at VenaZiel <\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Complete mobilization on the day of surgery<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Incapacity to work usually 1-3 weeks depending on the strain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Sports activities possible again after 3 weeks<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Very low complication rate with professional treatment<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2><b>Why VenaZiel Hernia Center Berlin?<\/b><\/h2>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Specialization in minimally invasive hernia surgery<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">State-of-the-art technology (TAPP, TEP, open surgery)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Class 1 outpatient surgery center in a central location (Checkpoint Charlie)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">High patient satisfaction &amp; individual care<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2><b>FAQ &#8211; Frequently asked questions<\/b><\/h2>\n<ol>\n<li><b>  Is a hernia always an emergency?<\/b><span style=\"font-weight: 400;\">  No, but if you are trapped, there is an acute danger to life &#8211; then go to hospital immediately!<\/span><\/li>\n<li><b>  How do I recognize an entrapment?<\/b><span style=\"font-weight: 400;\">  Severe pain, nausea, foul-smelling stools, hard swelling &#8211; seek medical help immediately.<\/span><\/li>\n<li><b>  Can a hernia exist without symptoms?<\/b><span style=\"font-weight: 400;\"> Yes. Many patients only notice a small bulge without pain. Nevertheless, there is a risk of sudden incarceration.<\/span><\/li>\n<li><b>  Does every hernia need to be operated on?<\/b><span style=\"font-weight: 400;\"> Sooner or later, yes. The only lasting therapy is surgery.<\/span><\/li>\n<li><b>  How long does a hernia operation take?<\/b><span style=\"font-weight: 400;\">  Between 30 and 60 minutes, usually performed on an outpatient basis.<\/span><\/li>\n<li><b>  Is surgery under general anesthesia necessary?<\/b><span style=\"font-weight: 400;\"> Generally yes, especially with TAPP or TEP. Open surgeries can also be performed under spinal anesthesia.<\/span><\/li>\n<li> <b> How quickly will I be fit again?<\/b><span style=\"font-weight: 400;\"> Light activities after a few days, sport after approx. 3 weeks.<\/span><\/li>\n<li><b>  How high is the risk of a relapse (recurrence)?<\/b><span style=\"font-weight: 400;\">  Less than 2 % with modern technology and experienced implementation.<\/span><\/li>\n<li><b>  What does a hernia operation cost?<\/b><span style=\"font-weight: 400;\"> The costs are usually covered by health insurance. For private patients or self-payers, we will inform you individually.<\/span><\/li>\n<li><b>  What distinguishes VenaZiel from other centers?<\/b><span style=\"font-weight: 400;\">  Our specialization, experience, state-of-the-art technology and focus on outpatient, gentle procedures with individual aftercare.<\/span><\/li>\n<\/ol>\n<h2><\/h2>\n<p><b>Scientific references<\/b><\/p>\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Simons MP et al.  <\/span><span style=\"font-weight: 400;\">European Hernia Society guidelines on the treatment of inguinal hernia in adult patients.<\/span><span style=\"font-weight: 400;\"> Hernia. 2009;13(4):343-403.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bittner R et al.  <\/span><span style=\"font-weight: 400;\">Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias.<\/span><span style=\"font-weight: 400;\"> Surg Endosc. 2019;33:3511\u20133549.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Herniamed Register.  <\/span><span style=\"font-weight: 400;\">Quality assurance in hernia surgery.<\/span> <a href=\"https:\/\/www.herniamed.de\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">www.herniamed.de<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Niebuhr H, Klinge U. <\/span><span style=\"font-weight: 400;\">Mesh implants in hernia repair.<\/span><span style=\"font-weight: 400;\"> Dtsch Arztebl Int. 2010;107(18):264-271.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Baucom RB et al.  <\/span><span style=\"font-weight: 400;\">Patient-centered decision making in inguinal hernia repair.<\/span><span style=\"font-weight: 400;\">  JAMA Surg. 2016;151(7):654-660.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Rosen MJ.  <\/span><span style=\"font-weight: 400;\">Minimally invasive hernia repair: a review.<\/span><span style=\"font-weight: 400;\"> Surg Clin North Am. 2013;93(5):1265-1278.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Weyhe D et al.  <\/span><span style=\"font-weight: 400;\">Inguinal hernia in men.<\/span><span style=\"font-weight: 400;\"> Deutsches \u00c4rzteblatt. 2020;117(23-24):401-406.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">International Guidelines for Groin Hernia Management. Hernia. 2018;22(1):1\u2013165.<\/span><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>An inguinal hernia is one of the most common surgical conditions worldwide. In Germany alone, over 300,000 inguinal hernias are operated on every year. Men are particularly affected, but women and children can also develop a hernia. The central question that many patients ask themselves is: \u201cDo I need surgery on my hernia immediately or can I wait and see?\u201d  <\/p>\n<p>In this article, we explain when an operation is necessary. We also show the risks of an untreated inguinal hernia. We also present modern, minimally invasive procedures. These include the TAPP method (transabdominal preperitoneal meshplasty).   <\/p>\n","protected":false},"author":1,"featured_media":15273,"parent":14820,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-14923","page","type-page","status-publish","has-post-thumbnail","hentry"],"_links":{"self":[{"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/pages\/14923","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/comments?post=14923"}],"version-history":[{"count":5,"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/pages\/14923\/revisions"}],"predecessor-version":[{"id":49638,"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/pages\/14923\/revisions\/49638"}],"up":[{"embeddable":true,"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/pages\/14820"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/media\/15273"}],"wp:attachment":[{"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/media?parent=14923"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}