Hernia repair surgery

About hernias

A hernia is when an organ or tissue pushes out through a weak spot in the surrounding tissue or muscle. Often this happens through the wall of your abdomen (tummy). You might notice a swelling or lump in the area. 

Different types of hernia are named according to where they are in your body. Some of the most common types include:

• Groin hernia – This could be either an Inguinal hernia which is more likely to affect men or a Femoral hernia which is closer to the upper thigh and more frequently affects women.
• Umbilical hernia – this is a hernia that forms on or near your belly button. They’re common in babies, but adults can develop them too.
• Incisional hernia – this is a hernia that happens when tissue pushes through a previous surgical wound.
• Epigastric hernia – these hernias develop in the centre of your body, between your belly button and breastbone.

Why do I need hernia repair surgery?

The most common type of hernia are not life-threatening, but getting them seen to can mean you live with less pain and are able to go about your daily activities more easily.

You can sometimes just push a hernia back into place. But eventually, you won’t be able to do this anymore. For most types of hernia, you’ll need surgery to permanently repair it. Hernia repair surgery involves pushing the lump back into place and repairing the weak spot in your muscle wall with stitches or mesh, so that it doesn’t happen again.

There’s also a risk that a hernia can become strangulated if it’s not repaired. This means the contents of the hernia become completely trapped and the blood supply is reduced or cut off. This can lead to the tissue becoming infected or dying, and other complications. This is then treated as an emergency.

How to get a hernia repair

You can have a hernia repair privately or on the NHS. Many private health care providers offer rapid access to hernia treatment. It you have health insurance, check whether hernia repair is covered.

Criteria and waiting times for hernia repair under the NHS differ depending where you live. For instance, in some areas, you may only be able to have hernia repair if your hernia is increasing in size or showing signs of strangulation. If you have a strangulated hernia, this will be treated as a medical emergency

Preparing for hernia repair

It’s important that you’re as healthy as possible before hernia repair surgery. If you smoke, it’s best to stop before the operation. It’s also good to lose any excess weight if possible, and to maintain a healthy diet. Try to keep physically active before your operation too.

A hernia repair may be done under local or a general anaesthetic a depending on the type of hernia. Your surgeon will let you know which, and whether there are any instructions you need to follow beforehand. You’ll often be treated as an outpatient and be able to go home on the day of a hernia repair, but this will depend on the type of operation you’re having. For large hernias or more complex procedures, you may need to stay in hospital for a few days. You’ll need to arrange for someone to drive you home.

What happens during hernia repair surgery?

There are several techniques for doing a hernia repair. The type of operation you have will depend on how big your hernia is, where it is and whether it’s a first or repeat operation. It’ll also depend on your age and general health, and your surgeon’s own expertise. But they all involve one of the following two main approaches.

• Open surgery involves making one large cut near to the site of your hernia. Your surgeon will gently push the protruding tissue back into your abdomen. For this type of surgery, they may close the site of the hernia by sewing it up, or more commonly, repair it using a piece of mesh. This can strengthen the weak area.
• Keyhole hernia repair involves inserting instruments through small incisions in your abdomen to repair the hernia. During keyhole surgery, your surgeon can see into your abdomen using a thin tube with a light and a camera on the end, called a laparoscope. Again, the surgeon may sew up the hernia or use mesh to repair it.

Recovery and what to expect after hernia repair

You’re likely to have some pain and discomfort while you recover from hernia repair. You’ll be given pain medication to help manage this and told about any side-effects of the procedure and potential recovery times. You may be advised to eat a high-fibre diet, and also take stool softeners and laxatives, to avoid constipation and straining.

You can start building up your normal activities gradually, including getting back to work, once you feel up to it. Don’t push yourself too quickly though – it can take several weeks to fully recover. You will usually be advised to avoid strenuous activities and heavy lifting for at least six weeks.

Potential complications of hernia repair

All surgical procedures carry some risk of complications. These will vary depending on the exact operation you’re having. But here are some of the most common complications associated with hernia repair.

• Difficulty passing urine after the operation (urinary retention).
• Blood or fluid collecting in the tissues. You may sometimes need treatment to remove this.
• Your hernia may come back again. This is less likely if your surgeon used mesh in your repair.
• Injury to another organ, such as your bowel. Your surgeon may be able to repair this during the operation.
• Chronic pain after the operation – this is a particular problem with inguinal hernia.
• Infection of your wound or the mesh used in the operation.

Complications of any operation can include allergic reactions to the anaesthetic and blood clots developing in your legs or lungs. 

How much does hernia repair surgery cost in the UK?

Hernia repair is often available through private medical insurance. Check with your insurer whether they will cover it.

You can also choose to self-fund this treatment. Typically, an initial consultation with the surgeon will cost between £150 and £250. The cost of the hernia surgery itself will vary depending on the type of hernia you have and the exact surgery you need. Hernia repair costs in the UK also vary depending on where you live. If you move forwards with the procedure, you’ll be offered one of the following.

• An all-inclusive ‘package price’, where you know the full costs before undergoing treatment. Not all consultants and hospitals offer this.
• A ‘fee-per-service’ deal, where you receive different invoices from the surgeon, the anaesthetist and the hospital. You often won’t know the full costs until you receive the invoices.

For more information, you can read our guide on self-pay.

References

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• Goethals A, Azmat C, Adams CT. Femoral hernia. StatPearls. www.ncbi.nlm.nih.gov, last updated 5 May 2021.
• Abdominal hernias. Medscape. emedicine.medscape.com, updated 23 July 2019.
• Hope WW, Tuma F. Incisional hernia. StatPearls. www.ncbi.nlm.nih.gov, last updated 26 June 2020.
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• A dangerous waiting game? A review of patient access to inguinal hernia surgery in England. British Hernia Society & Royal College of Surgeons, July 2018. www.rcseng.ac.uk
• Coste AH, Jaafar S, Parmely JD. Umbilical hernia. StatPearls. www.ncbi.nlm.nih.gov, last update 21 July 2020.