Hernia Surgery

What is a Hernia?

A hernia occurs when tissue—often part of the intestine or abdominal fat—pushes through a weakened area in the abdominal wall. It can resemble a bulge that’s more visible when standing and may flatten when lying down.

Hernias most commonly occur in:

Hernia repair is one of the most frequently performed surgeries in Australia. It is estimated that up to 27% of men and 3% of women will develop an inguinal hernia in their lifetime.

What Causes a Hernia?

Hernias may be present at birth or develop over time due to pressure on weakened abdominal muscles. Common contributing factors include:

Chronic cough
Constipation or difficulty urinating
Heavy lifting
Obesity
Previous abdominal surgery
Family history of hernias
Male sex (hernias are more common in men)

Symptoms of a Hernia

Hernias may not cause symptoms initially and are often discovered during a routine exam or imaging. When symptoms do occur, they can include:

Potential Complications

If left untreated, hernias can enlarge or lead to serious complications:

Incarceration: The herniated tissue becomes trapped and cannot be pushed back in. This is painful and may lead to further complications.
Obstruction: A segment of bowel becomes blocked, causing pain and inability to pass stool or gas. This requires urgent surgery.
Strangulation: The blood supply to the herniated tissue is cut off, causing tissue death. This is a surgical emergency.

Do I Need Surgery?

Surgery is the only definitive treatment for a hernia. Support garments like trusses may provide temporary relief but do not fix the underlying problem. Surgical options include:

Open Hernia Repair: An incision is made over the hernia site. The tissue is pushed back into place, and the wall is reinforced with mesh or stitches.
Laparoscopic (Keyhole) Repair: Small incisions are made and the hernia is repaired using a camera and specialised instruments. A mesh is usually placed over the defect. Most inguinal and some incisional hernias are best repaired laparoscopically, offering smaller scars, less post-operative pain and faster recovery. Umbilical hernias are best repaired through an open repair via a small umbilical incision.

Note: In certain cases, particularly for men with small, minimally symptomatic inguinal, umbilical and incisional hernias, a ‘watchful waiting approach’ may be appropriate. This means monitoring the hernia over time without immediate surgery, especially if there are no complications or discomfort. Your surgeon will discuss whether this option may be suitable for you.

Mesh Repair

Modern hernia repairs commonly use surgical mesh to reinforce the abdominal wall. The mesh is typically made of biocompatible material that integrates with your tissue and helps prevent recurrence. It covers a larger area without tension, which reduces the risk of the sutures pulling through.

Chronic Pain Management

While rare, some patients may experience long-term discomfort or pain after hernia repair. This is more likely after open inguinal repairs. If pain persists, it can usually be managed with physical and massage therapy, medications, nerve blocks, or in very rare cases, surgical revision.

Preparing for Surgery

Preoperative preparation may include:

Blood tests, chest X-ray, or ECG if required
A detailed discussion of the procedure and signing of consent forms
Fasting for at least 6 hours before surgery (you’ll be advised on exact timing)
Reviewing your medications with your surgeon and anaesthetist

Important medication guidance:

Other instructions:

Recovery After Surgery

Driving: Avoid driving for at least one week post-operatively or until you can comfortably perform an emergency stop.

Returning to work:

Exercise: Gentle walking is encouraged. Avoid core strengthening or high-impact exercises until cleared by your surgeon (typically after 4–6 weeks).

Recovery After Surgery

Hernia repair surgery has a high success rate, particularly with mesh reinforcement. The risk of recurrence is low. Following post-operative instructions, maintaining a healthy weight, and avoiding excessive strain can reduce your risk of recurrence.

Possible Complications

While hernia surgery is generally safe, all operations carry some risks. Potential complications include:

Wound infection or scarring
Recurrence of the hernia
Post-operative pain or nerve irritation (particularly in open inguinal repairs)
Injury to nearby organs (bladder, bowel, blood vessels)
Testicular complications (rare in inguinal hernia repair)
General risks: bleeding, blood clots, urinary retention, chest infection, or anaesthetic reactions