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Hernia Surgery
A hernia can cause discomfort and may get in the way of day-to-day activities, particularly when standing, bending over or straining.
A hernia is a bulge that happens when an inner body part, such as bowel, pushes through a defect or weakness typically in the abdomen or groin. The wall of the abdomen normally forms a natural corset that holds the internal organs inside it. A defect or weakness in this wall can result in loss of this support.
Some people are born with a defect or weakness in the abdominal wall. Others develop this with time due to repeated straining, ageing, heavy lifting or previous surgery.
A hernia will not go away without surgery to repair it, although not every hernia needs to be repaired immediately. Hernias can become larger or more noticeable over time, and the decision to repair a hernia depends on symptoms, size, type, risk of complications, general health and patient preference.
There are different types of abdominal hernia depending on their location and cause. The commonest types are inguinal hernias, which are found in the groin, and umbilical hernias, which occur in or around the belly button.
A femoral hernia can also be found in the groin, although it is less common than an inguinal hernia. Hernias that arise in the upper part of the abdomen above the belly button are known as epigastric hernias. If a hernia happens as a result of previous abdominal surgery, this is known as an incisional hernia and is usually found close to where the surgical scar is located.
Your doctor will usually be able to diagnose an abdominal hernia by examining your abdomen or groin. Occasionally, an ultrasound scan, CT scan or MRI scan may be required to confirm the diagnosis or to understand the hernia in more detail.
Hernias can cause discomfort and occasionally pain. Larger hernias can get in the way of daily activities, particularly when bending forward, standing for long periods, straining or getting dressed.
If your hernia is noticeable or bothersome, repair may be recommended if you are fit for the procedure. You may choose not to repair a small or unnoticeable hernia, especially if it is not causing symptoms. However, surgical repair may still be recommended for some small hernias if they are prone to complications. Your consultant will discuss the treatment options with you in clinic and explain whether they believe your hernia requires repair.
Hernias tend to grow in size if they are not repaired, and hernias that are initially small or less noticeable can become more obvious with time. Hernias that contain bowel can occasionally develop complications such as bowel blockage or loss of blood supply if the bowel becomes trapped or twisted. If a hernia becomes very painful, firm, tender, discoloured, impossible to push back in, or is associated with vomiting or abdominal swelling, urgent medical advice should be sought.
Repair options
Keyhole repair may be suitable for certain hernia types such as groin hernias. It uses small incisions and can support a quicker early recovery for some patients.
| Approach | How it is performed | When it may be suitable |
|---|---|---|
| Keyhole repair | A few small incisions, 5–12 mm, under general anaesthetic. | May be suitable for small hernias and many groin hernias, including selected patients with hernias on both sides or a previous open groin repair. |
| Open repair | One incision is made close to the hernia. Open repair is commonly performed under general anaesthetic, although local anaesthetic may be considered for selected patients who are not suitable for, or do not wish to have, a general anaesthetic. | Open repair may be used depending on the hernia type, surgeon and patient preference, previous surgery, very large or complex hernias, or when keyhole surgery or general anaesthesia is less suitable. |
The choice of procedure will depend on the type, size and number of hernias, whether you have had previous hernia or abdominal surgery, your medical history and, to a certain degree, your preference. You will have the opportunity to discuss open and keyhole options with your surgeon in more detail in clinic.
Questions patients ask
A hernia can cause a lump or swelling, discomfort, aching, heaviness or pain with standing, bending, lifting or straining.
Not always. Small hernias that are not causing symptoms may be monitored, but some small hernias are repaired if they are prone to complications.
No. A hernia does not resolve without surgery, although symptoms and the need for repair vary between patients.
Hernia surgery is a commonly performed operation and is generally safe for suitable patients. As with any operation, the safest approach depends on the type of hernia, your general health, previous surgery, medications and anaesthetic risk. These factors will be reviewed during your consultation so that the benefits and risks of surgery can be discussed in your individual case.
Most patients recover well, but complications can occur. These may include bleeding, bruising, wound infection, swelling, fluid collection, pain, numbness, recurrence of the hernia, problems related to the mesh if mesh is used, or complications related to the anaesthetic. Serious complications are uncommon, but your surgeon will discuss the risks that are most relevant to your type of hernia and planned repair.
Keyhole hernia repair is usually performed under general anaesthetic using several small incisions. It may offer benefits such as less early wound discomfort and a quicker early return to some activities for selected patients, particularly where both groins need repair or where a previous open groin repair has been performed.
Open hernia repair uses an incision close to the hernia and remains a very effective approach. It may be preferred for some large, complex, recurrent or incisional hernias, after certain previous operations, or when keyhole surgery is not the best option. The safest and most appropriate approach depends on the type of hernia, previous surgery, medical history and your priorities.
Mesh is commonly used for groin and larger abdominal hernias to reduce tension and recurrence risk. Some small hernias may be repaired with sutures alone.
Recovery depends on the type of hernia, the operation performed and your general health. Many groin, umbilical and smaller hernia repairs are performed as day-case procedures, or with an overnight stay if needed. Larger or more complex abdominal wall hernia repairs may require a longer hospital stay and a more gradual recovery.
Bruising, swelling and soreness are common in the first few days. Most patients can return to light activity within a few days, but lifting, strenuous exercise and return to work should be guided by the type of repair and the advice given after surgery.
Return to work depends on the type of hernia, the operation performed and the physical demands of your job. Some patients with desk-based work may be able to return within one to two weeks, while those with heavy manual work may need longer. Your surgeon will give guidance based on your operation and recovery.
You should not drive until you can move comfortably, perform an emergency stop, wear a seatbelt safely and are no longer taking medication that could impair driving. Many patients wait at least several days to a couple of weeks, depending on the operation and recovery. You should also check your car insurance policy if unsure.
Gentle walking is usually encouraged early after surgery. Heavier lifting, strenuous exercise and abdominal workouts should be avoided until your surgeon advises that it is safe. The timing depends on the type and size of hernia repaired, whether the repair was open or keyhole, and your individual recovery.
Seek urgent advice if a hernia becomes very painful, cannot be pushed back in, is associated with vomiting, abdominal swelling or symptoms of bowel obstruction.
A consultation can help clarify the diagnosis and whether repair is likely to help.
