The Inoperable Hernia

Kevin C. Petersen, M.D.

"Discretion is the better part of valor." 

A neglected hernia can grow so large that all intestine and other abdominal organs move out of the abdominal cavity proper, in essence losing eminate domain. The remaining abdominal wall fascia and muscle contracts leaving no room for these organs to be moved back into. Repair of such hernias may require reconstruction of an entirely new anterior abdominal wall. This is dangerous and often not successful.

It is possible to recreate a container wall but the abdominal wall is much more complex than this. The abdominal wall is slippery allowing the intestine to more freely. The abdominal wall is contractile, assisting respiratory function. The abdominal is compliant, limiting intrabdominal pressure and avoiding respiratory function embarrassment. The abdominal wall helps support the spine and is an integral part of torso movement. Simply replacing abdominal container function does not restore these other functions.

We repair hernias to avoid hernia complications. An inoperable hernia is a hernia that cannot be repaired without truly harming the patient, outweighing the singular goal.


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