Hernias occur at natural weak points in the abdominal wall, such as the groin or belly button. Fatty tissue or bowel can push through this weak point, which can cause pain and risk strangulation of the bowel trapped within it. Hernias do not get better on their own and tend to get bigger over time. As a result, if you have a hernia, the chances are your doctor will refer you for hernia surgery to repair it.
Some hernias may not need immediate treatment, or may not need treatment at all. For this reason, if you have symptoms of a hernia, we always recommend booking a consultation. The right treatment depends on the size and location of the hernia and the risk of complications from it.
Do I need hernia surgery?
Your doctor is likely to recommend surgery if:
- tissue becomes trapped in the abdominal wall and cannot be pushed back, which is called incarceration
- the hernia becomes strangulated, which cuts off the blood supply to the trapped tissue and is a surgical emergency
- the hernia is not going away, is causing pain or is getting large
Keyhole and Open Repair Compared
There are two main ways to repair a hernia. Both take place in hospital, and most people go home the same day.
Laparoscopic (keyhole) surgery
You will need a general anaesthetic for this type of repair. Your abdomen is inflated with a harmless gas, which gives your surgeon a view of the hernia from the inside. A few (usually three) small incisions in the abdominal wall allow a tiny camera and keyhole instruments to be inserted, and a mesh is placed to repair the hernia.
There tends to be a quicker recovery with laparoscopic surgery, and the risk of long-term discomfort is lower than with open surgery. The keyhole approach also lets the surgeon check both sides of the groin and repair a second hernia at the same time if one is found. Your surgeon will decide whether this approach is suitable for you. You can read more about how keyhole techniques work on our laparoscopy treatment page.
Open surgery
An incision through the skin over the hernia gives access to the weakened area, which is then repaired using mesh. Open surgery is usually done under general anaesthetic, although it can sometimes be done under local anaesthetic, where you are awake but feel no pain. Recovery tends to take longer, and the risk of chronic groin pain is higher than with laparoscopic surgery.
Why Is Mesh Used?
Mesh is a thin, flexible sheet that sits over the weak area and acts as a scaffold. Over the following weeks your own tissue grows into it, which strengthens the repair. Most hernia repairs in the UK use mesh because it lowers the chance of the hernia coming back compared with stitches alone. Some very small hernias, such as certain belly button hernias, can be closed with stitches only. Mr Clarke will explain which repair he recommends for you and why.
What Happens on the Day
Before your operation, the hospital will tell you when to stop eating and drinking. You will need someone to drive you home, as you should not drive after a general anaesthetic.
The operation itself usually takes between 30 and 90 minutes, depending on the type of hernia and the technique used. Afterwards, it is normal to have:
- some pain around the wound for a few days
- bruising or swelling around the wound or groin for a couple of weeks
- bloating or shoulder pain for a day or two after keyhole surgery, caused by the gas used during the operation
Recovery Timeline
Most people make a full recovery within 4 to 6 weeks, although it can take longer. As a general guide:
- First few days: take simple painkillers such as paracetamol or ibuprofen, and go for short, gentle walks
- 1 to 2 weeks: most people return to desk-based work and light activities
- Around 2 weeks: baths and swimming are usually fine once the wound has healed
- Driving: only when you can wear a seatbelt comfortably and do an emergency stop without pain, and after checking with your insurer
- 4 to 6 weeks: avoid heavy lifting and strenuous exercise until this point, and allow up to 6 weeks off if your job involves heavy lifting
Possible Risks and Complications
Hernia surgery is usually safe. However, as with any surgery, there are some risks:
- wound infection
- soreness, bruising or swelling
- pain or numbness in the groin that lasts longer than three months
- blood clots
- the hernia coming back (recurrence)
If surgery is not suitable or is not recommended for you, other options are available. You may be advised to wear a corset, binder or truss to hold the hernia in place and ease discomfort. These do not repair the hernia, but they can help manage symptoms.
Frequently Asked Questions
You will be asleep or numb during the operation, so you will not feel any pain. Afterwards, most people have soreness around the wounds for a few days, which is usually well controlled with simple painkillers.
Most planned hernia repairs are carried out as a day case, so you can usually go home the same day as your operation.
Keyhole surgery leaves a few small scars around the belly button and lower abdomen. Open surgery leaves one longer scar over the hernia. Both types of scar usually fade over time.
It can, although this is uncommon after a mesh repair. Following the lifting advice during recovery, keeping to a healthy weight and not smoking all help to lower the risk.
Walking is encouraged straight away. Light exercise can usually restart after about 2 weeks, but avoid weights and strenuous training for at least 4 to 6 weeks.
Book a Hernia Consultation
If you have a hernia and would like to talk through your options, Mr Clarke offers private consultations in Poole and Bournemouth. You can find out where he operates and how to book on our hernia surgery in Dorset page, or call 07501 150298 to book an appointment today.