General Surgery

Hernia: What You Need to Know Before Your Operation

A hernia occurs when an organ or piece of tissue pushes through a weakness in the surrounding muscle wall, creating a visible or palpable bulge. Hernias are extremely common, affecting around one in four men at some point during their lifetime, and while they may start small and cause only minor discomfort, they do not resolve on their own and carry the risk of serious complications if left untreated.

Types of Hernia

The most common types seen in surgical practice include:

Inguinal hernia, through the groin muscles, the most common type, predominantly in men
Femoral hernia, just below the groin crease, more common in women, higher risk of complications
Umbilical hernia, through the navel, common in both adults and infants
Incisional hernia, through a previous surgical scar in the abdominal wall
Epigastric hernia, in the upper abdomen between the navel and sternum
Parastomal hernia, adjacent to a stoma, a common complication of bowel surgery

Symptoms to Look Out For

The classic presentation is a soft bulge or lump, typically most obvious when standing, coughing or straining, and reducible (disappearing) when lying down. Associated symptoms include a dragging ache or sharp pain at the hernia site, particularly with physical exertion. Groin hernias in men may extend into the scrotum.

Warning signs requiring urgent attention:

A sudden increase in pain, inability to push the hernia back in, vomiting, or redness and hardness of the lump are signs of strangulation, a surgical emergency where the blood supply to the herniated tissue is cut off. Seek emergency care immediately if these symptoms develop.

Why Hernias Should Not Be Ignored

Many people live with hernias for years, particularly if symptoms are mild. However, hernias do not shrink or resolve without treatment. Over time, most hernias enlarge and become increasingly symptomatic. The most serious risk is strangulation, which requires emergency surgery and carries significantly higher risks than planned elective repair. Early elective repair is therefore safer and more straightforward.

Modern Hernia Repair: Laparoscopic and Robotic Surgery

The majority of hernia repairs are now performed using minimally invasive techniques, either laparoscopic (keyhole) or robotic surgery, rather than open surgery. Both approaches use small incisions and a camera, with the hernia repaired using a synthetic mesh placed behind the abdominal wall to reinforce the defect.

Laparoscopic Repair

Robotic Repair

Robotic hernia repair offers enhanced three-dimensional visualisation and greater instrument precision compared to standard laparoscopy. This is particularly advantageous for complex, large or recurrent hernias. Patients benefit from smaller incisions, less post-operative pain and equivalent or superior long-term outcomes.

What to Expect After Surgery

Most hernia repairs are performed as day cases. Return to driving is typically within one to two weeks, light work within one to two weeks, and full physical activity within six to eight weeks. Recurrence rates with mesh repair are below two percent when performed by an experienced surgeon.

If you have a hernia that is causing symptoms, early specialist review is strongly advisable. The earlier a hernia is repaired, the simpler and safer the procedure is likely to be.

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