For asymptomatic or minimally symptomatic hernias, a watchful waiting approach, under informed consent, is advocated.
Surgical treatment should only be offered when one of the following criteria is met:
- symptoms of pain or discomfort that interfere with activities of daily living,
- the hernia is difficult or impossible to reduce,
- it is an Inguino-scrotal hernia,
- the hernia increases in size month on month.
- All suspected femoral hernias should be referred to secondary care due to the increased risk of incarceration/strangulation.
- All suspected umbilical hernias should be referred to secondary care due to the increased risk of strangulation of the bowel.
Surgical treatment should only be offered when BOTH of the following criteria are met:
- Symptoms of pain/discomfort that interfere with activities of daily living
- Appropriate conservative management has been tried first e.g. weight reduction where appropriate.
Not routinely funded
Diastases/Divarication of Recti
Diastases / Divarication of recti is a separation between the left and right side of the rectus abdominis muscle and causes a protrusion in the mid-line, but is not a ‘true’ hernia and does not carry the risk of bowel becoming trapped within it and thus does not require repair. The CCGs consider repair of divarication of recti as a cosmetic procedure and a low priority. Evidence suggests that divarication does not carry the same risks as that of actual herniation.
|Latest change to document
||8 February 2018
||22 May 2018
|Next Review date