Abdominal Wall Hernias in the Elderly
Abdominal wall hernia repair is the most common surgical procedure in the United States. With the US elderly population expected to nearly double in size from 2012 to 2050 (Ortman et al., US Census 1964:1-28, 2014), physicians should expect to see an increasing number of elderly patients presenting for evaluation and treatment of abdominal wall hernias. The elderly population deserves special attention as this population often has more comorbidities and shorter life expectancy as compared to a younger population. Thus, it is important for clinicians to discuss goals of care and the risks of treatment options with their elderly patients. Although there is a general paucity of data on outcomes in the elderly hernia population, more data is becoming available for review. Laparoscopic herniorrhaphy appears to be a safe technique for many elderly patients. Watchful waiting has also arisen as a potential option for patients with asymptomatic or minimally symptomatic groin and ventral hernias. This chapter will focus on the preoperative evaluation, repair, and complications of inguinal and incisional/ventral hernias in the elderly. Other hernias will be discussed separately at the end of the chapter.
