When considering hernia surgery, a common question arises regarding the removal of fat. The answer depends on the specific circumstances of the hernia and the type of tissue involved. Surgeons may manage fat tissue differently based on its condition and its role in the hernia.
Hernias and Their Contents
A hernia occurs when an internal organ or tissue pushes through a weakened area in the muscle or tissue wall that normally contains it. Most hernias develop in the abdomen or groin, appearing as a noticeable bulge. The opening is called a hernial orifice, and the protruding tissue forms a hernia sac. This sac can contain various internal structures.
Fat tissue is frequently found within a hernia sac. This is because abdominal fat, such as the omentum, is often the first tissue to push through a weakened abdominal wall when pressure increases. While fat is a common content, a hernia sac can also contain other organs, such as parts of the intestine.
How Surgeons Manage Herniated Tissue
During hernia repair, surgeons employ different strategies to manage the contents of the hernia sac, including fat. The approach taken depends on factors such as the tissue’s viability, the hernia’s size, and the surgeon’s judgment. Two primary methods are reduction and excision.
Reduction involves carefully pushing viable tissue, including healthy fat, back into the abdominal cavity. This is the preferred method for healthy, uncompromised tissue that can be safely returned to its normal anatomical position. In many inguinal, umbilical, and smaller ventral hernias, the omentum is often present, and if healthy, it is typically reduced.
Excision of tissue occurs when it is non-viable, damaged, or present in excess and cannot be safely returned. This includes fat that may be strangulated, necrotic, or so bulky it interferes with the repair or mesh placement. If a piece of omentum is incarcerated and cannot be safely reduced, it may be cut and removed. The goal is to repair the anatomical defect and ensure proper healing, sometimes necessitating the removal of certain tissues.
Distinguishing Hernia Surgery from Cosmetic Procedures
Hernia surgery is a medical procedure aimed at repairing an anatomical defect and alleviating symptoms, which can include pain or discomfort. Any removal of fat during this surgery is strictly for medical necessity, not for aesthetic purposes like body contouring.
Cosmetic procedures, such as liposuction or abdominoplasty (tummy tuck), are performed to remove excess fat and skin for aesthetic improvement. While some patients might have both a hernia and excess abdominal fat, and occasionally these procedures can be combined, the primary objective of hernia surgery remains functional restoration. The decision to remove fat during hernia repair is based on clinical considerations to ensure a successful repair and prevent complications, rather than to achieve a specific body shape.