For hernia surgery, a healthy weight (BMI 18.5-25) is ideal, but many surgeons recommend a target BMI of 30 or below (obesity class I) to significantly lower risks like infection, poor healing, and recurrence, with a BMI over 35-40 often requiring weight loss before surgery to improve outcomes, especially for complex cases.
What is the ideal BMI before hernia surgery? There's no single ideal BMI, but generally a BMI between 18–25 is considered optimal for reducing surgical risks.
Unfortunately, it is not uncommon around the world for hernia patients to be rejected for surgery for various reasons, including their age, breathing or heart problems, or sometimes because of the complexity of the hernia itself.
The "6-2 rule" for inguinal hernias in children is a guideline for surgical timing: Neonates (birth-6 weeks) need surgery within 2 days; children 6 weeks to 6 months need it within 2 weeks; and children over 6 months need it within 2 months, because younger infants have a higher risk of incarceration (strangulation). For adults or older children with reducible hernias, some sources suggest seeing a surgeon if symptoms last over six weeks.
The higher your BMI, the greater the lateral tension caused by fat pushing against your abdominal wall. Too much pressure results in a hernia recurrence. Because of this, you probably need to lose weight before hernia surgery. Your surgeon may recommend a weight-loss program or consultation with a bariatric center.
Conclusions: BMI > 33.67 kg/m2 was the identified threshold at which hernia recurrence rate significantly increased in patients in a large county hospital system who underwent ventral hernia repair, and the risk continued for up to 6 years.
Gregory Dumanian of Northwestern Plastic Surgery discusses what to do in preparation for hernia surgery.
Certain factors, including smoking, diabetes, and being overweight increase your risk of complications after hernia surgery. You may not be a candidate for hernia surgery if these are health concerns for you, and you will need to discuss these with your surgeon.
They appear as small bulges and may cause symptoms such as pain or discomfort near the abdomen. Large hernia – They are usually from 5-10 cm in diameter and are easily noticeable. They almost always cause painful symptoms, along with nausea and vomiting. Very large hernia – They exceed 10 cm or above in diameter.
Incisional hernias: Whenever the body wall is cut, such as if you have had an open appendix operation or a Caesarean section during childbirth, the healed scar is never as strong as the original body wall. Hernias are common along incision lines and can be one of the most difficult hernias to repair.
Changes to the hernia, for example, if it becomes firm, tender, or if it cannot be pushed back in. Pain that worsens or comes on suddenly. Nausea or vomiting. Fever.
Elective hernia surgery is a low-risk procedure. Patients with emergency operations are approximately a decade older than patients treated electively. Emergency operations are 3 times more common in femoral than in inguinal hernia, and they carry a substantial mortality risk especially if bowel resection is performed.
After surgery to repair your hernia, you are likely to have pain for a few days. You may also feel tired and have less energy than normal. This is common. You should feel better after a few days and will probably feel much better in 7 days.
In obese patients, the characteristics of a hernia, such as its location, size, recurrence risk, and any additional problems, as well as the degree of obesity, should be considered when planning hernia surgery. As the degree of obesity increases, the risk of complications after hernia surgery increases.
Hernia Surgery Preparation
Preoperative preparation includes blood work, medical evaluation, chest x-ray and an EKG depending on your age and medical condition. After your surgeon reviews with you the potential risks and benefits of the operation, you will need to provide written consent for surgery.
Patients with a BMI of 30 to 34.9 are considered suitable surgical candidates only if they have no more than two comorbid conditions; patients with a BMI of 35 to 38 should have only minor peripheral procedures with regional or local anesthesia; and patients with a BMI higher than 38.1 should have surgery only “under ...
One to two weeks after your hernia surgery, try walking at a gentle pace for 15 minutes once a day. Try to avoid stairs or hills as you exercise. Once you reach the two-week or more mark from your surgery, walk for up to 30 minutes each day at a reasonable pace.
Abstract: Hiatal hernias (HH) can be classified into 4 types, with type IV paraesophageal hernias (PEH) being the most complex. Type IV PEH contain stomach and other abdominal viscera, such as colon, small bowel, pancreas or spleen, within the hernia.
It is classed as major surgery and has a longer recovery. Minimally invasive surgery, called laparoscopic hernia repair, makes smaller incisions and uses tiny instruments to perform the hernia repair with the help of a laparoscope which is a slender tool with a tiny video camera and light on the end.
Approximately 1 in 10 patients experienced decision regret following ventral and incisional hernia repair with laparoscopy, as the much-hyped and anticipated benefits of faster recovery and minimal pain did not match their actual postoperative experiences.
These studies have shown that delays by even two days after admission are associated with increased postoperative complications, hospital costs, and lengths of stay. For strangulated hernias, consensus guidelines currently recommend immediate surgery.
Inguinal hernias are more common in certain age groups.
Gentle activity around the home will help your wound heal. After 1 week, you should feel more comfortable and be able to walk short distances and do light activities. Do not do any heavy lifting or strenuous exercise for 6 weeks. This will help with healing and prevent the hernia from returning.
Take a shower the night before or the morning of your operation. Your surgeon may ask you to use an antibiotic soap. Please DO NOT shave your belly or groin areas. Stop eating and drinking at the time your doctor tells you before the operation.
The main cause of a hernia is a combination of muscle weakness and increased pressure in the abdomen, allowing tissue or organs to push through a weak spot in the surrounding muscle wall, often due to straining from activities like heavy lifting, chronic coughing, or constipation, combined with underlying weak spots that can be congenital or develop from aging, obesity, or previous surgery.