Hernia
Medical review in progress · HER-001 · Medical Review
In short
Pending confirmation · IN-021 · sources: 1234Not always. A small groin (inguinal) hernia that causes no symptoms can sometimes be safely watched. Surgery is usually recommended if a hernia is painful, getting bigger or affecting daily life, for femoral hernias, and for most umbilical hernias in adults, which are unlikely to get better on their own. A hernia that suddenly becomes very painful, hard or cannot be pushed back needs urgent medical help.
Types of hernia
Pending confirmation · IN-021 · sources: 1A hernia happens when part of an internal organ, such as the bowel, or fatty tissue pushes through a weak area in the muscle wall of the tummy. It often shows as a lump or swelling that may disappear when you lie down, and may ache when you cough, lift or strain.
Inguinal hernias appear in the groin and are the most common type, especially in men. Femoral hernias appear at the top of the inner thigh and are more common in women. Umbilical hernias appear at or near the belly button. Incisional hernias develop through the scar of a previous operation.
Hiatus hernias, where part of the stomach moves up into the chest, are different: they are usually managed with medicines and are not covered here.
When surgery is recommended
Pending confirmation · IN-021 · sources: 1234A hernia does not go away by itself, but not every hernia needs an operation straight away. A small inguinal hernia that causes no symptoms may be watched, with a plan to repair it if it starts to cause problems.
Surgery is usually recommended if the hernia is painful, getting bigger or getting in the way of work or exercise. Femoral hernias are usually repaired because they have a higher risk of complications, and most umbilical hernias in adults are repaired because they are unlikely to get better on their own. The decision depends on the type and size of hernia, your symptoms and your general health.
Call 999 or go to A&E if you have sudden, severe pain in a hernia, the lump becomes firm, tender or discoloured and cannot be pushed back, or you have tummy pain with vomiting or cannot pass wind or poo. These can be signs that the bowel is trapped (obstructed or strangulated), which needs emergency surgery.
Open and keyhole repair
Pending confirmation · IN-021 · sources: 1In open repair, the surgeon makes one cut over the hernia, puts the tissue back in place and strengthens the weak area, usually with a mesh. In keyhole (laparoscopic) repair, the same is done through a few small cuts using a camera and fine instruments.
Keyhole repair is often suggested for hernias on both sides or for a hernia that has come back after open repair; open repair can be done under local or general anaesthetic and suits some people better. The best option depends on the hernia, your health and your preferences, and your surgeon will discuss the benefits and risks of each with you.
Most people go home on the same day.
Recovery, work and driving
Pending confirmation · IN-021 · sources: 12Full recovery usually takes up to 4 to 6 weeks. Start walking and moving gently straight away, but avoid heavy lifting and strenuous exercise for at least 4 to 6 weeks.
Most people return to desk-based work within 1 to 2 weeks; if your job involves heavy lifting or manual work, you may need about 6 weeks. You can drive when you can wear a seatbelt and do an emergency stop without pain — check with your care team and your insurer first.
Possible problems include bruising and swelling, wound infection, long-lasting pain or numbness in the groin, and the hernia coming back. Your surgeon will explain how likely these are for you.