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Hernia Surgery

A hernia is a bulge of fat or bowel through a weak spot in the abdominal wall. It does not heal on its own, and most hernias are best repaired before complications develop.

Types of hernia

  • Inguinal hernia: in the groin; by far the most common, especially in men.
  • Femoral hernia: just below the groin crease; more common in women and has a high risk of strangulation.
  • Umbilical and para-umbilical hernia: at or near the belly button.
  • Incisional hernia: through the scar of previous abdominal surgery, including caesarean section.
  • Epigastric hernia: in the midline above the navel.
  • Hiatus hernia: part of the stomach slips into the chest, causing reflux.

Symptoms

A soft swelling that appears on standing, coughing or straining and disappears on lying down, often with a dragging ache.

Seek emergency care if the bulge becomes hard, tender, red or cannot be pushed back, especially with vomiting, severe pain or inability to pass gas. These are signs of an obstructed or strangulated hernia.

Surgical options

Laparoscopic repair (TEP and TAPP)

Through three small keyhole cuts, the surgeon places a mesh behind the abdominal wall muscles. TEP (totally extraperitoneal) stays outside the abdominal cavity; TAPP (transabdominal preperitoneal) goes through it. Benefits include less pain, faster return to work and the ability to repair both sides at once – ideal for bilateral and recurrent inguinal hernias.

Open mesh repair (Lichtenstein)

A single 5–7 cm groin incision is used to reinforce the weak area with mesh. It can be done under spinal or even local anaesthesia, making it a good choice for older or higher-risk patients.

Umbilical and incisional hernias

Small defects may be stitched; larger ones are reinforced with mesh using open, laparoscopic (IPOM, eTEP) or robotic techniques. Abdominal wall reconstruction may be needed for very large hernias.

Recovery

  • Most inguinal hernia repairs are day-care or one-night stays.
  • Walking is encouraged the same day.
  • Desk work in 3–7 days after laparoscopic repair; 1–2 weeks after open repair.
  • Avoid heavy lifting (over about 10 kg) for 4–6 weeks.
  • Recurrence rates with mesh repair are around 1–5%.

Is watchful waiting an option?

For men with a small inguinal hernia that causes few or no symptoms, careful observation is a safe alternative, although most eventually need surgery. Femoral hernias, painful hernias and those in women should generally be repaired.

Frequently asked questions

Can a hernia go away without surgery?

No. A belt or truss may hold it temporarily, but the defect in the muscle remains and usually enlarges over time.

Is mesh safe?

Modern lightweight meshes used for groin and abdominal hernias are safe and greatly reduce recurrence. Mesh problems are uncommon.

When can I drive after hernia surgery?

Usually when you can brake hard and turn without pain – often 1 week after laparoscopic repair.

Last reviewed: October 2026. This page is general information and does not replace advice from your own doctor.