As you are aware, hernia is used to describe the situation where the contents of one cavity have pushed their way into an adjacent cavity, or external to the wall. The type of hernia we worry about are those abdominal or pelvic hernia with a small 'neck' where loops of bowel or other content could get caught up, become obstructed and strangulate.
The normal treatment for most abdominal hernia is a mesh repair however this only works for smaller hernia but is very successful with few complications in a normal healthy adult.
The location you mention is a bit confusing as it is not a normal site for abdominal hernia unless there has been a previous operation in this area. If you are referring to a 'hiatus hernia' this is a slightly different hernia where the top of the stomach has poked through the opening of the diaphragm into the chest cavity. This causes increased reflux of stomach contents and can be associated with GORD.
If there was very large herniation then in theory the lung volume for expansion would be restricted and there would be shortness of breath.
Regardless of the type of hernia, the same rules apply for any surgical intervention in a patient with your husband's problems. The first is as a diabetic he will have reduced wound healing and increased risk of infections leading to post operation wound complications which can take a long time to heal and put him at risk of hospital acquired infections such as Staph aureus. In addition, with a history of embolism then he is at risk of clotting problems post surgery and this can lead to increased risk of DVT, pulmonary embolism and stroke.
So, if your husband is not experiencing significant deterioration in quality of life, I would be inclined to monitor and leave alone for the moment.
Does this help? I will be off line now for several hours but I will check back in tomorrow evening to see if you need any more help.
Regards
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