A hernia is a general term used when fatty tissue, or an internal part of the body such as the bowel, pushes through a weakness in the muscle or surrounding tissue wall. This forms a bulge or lump in the muscle wall of the tummy (abdomen).
This muscle wall can be weakened from:
- surgery you've had
- giving birth
- lifting heavy objects
- being overweight
It is also possible for a hernia to happen for no reason at all.
Not everyone who has a hernia has symptoms. Sometimes, when your muscles are relaxed, the bulge or lump can be pushed back through the muscle wall. However hernias can get bigger and become more painful and uncomfortable so this may not always be possible.
Although having a hernia is not usually a serious condition, hernias will not go away without having surgery to repair it. This means there is no long term alternative to having surgery to repair a hernia.
Sometimes a hernia can become stuck out and very painful. This is called a strangulated hernia and needs an urgent operation. This happens to about 2 in 100 people with an inguinal hernia each year.
Surgery is usually carried out as day surgery so you can go home on the same day but sometimes people need to stay in hospital overnight.
Types of hernia
There are many different areas where a hernia can occur. You can read more about the different types on the NHS website. They include:
- inguinal hernias: a bulge in your groin at the top of your inner thigh
- femoral hernias: a bulge into your groin at the top of your inner thigh, lower than an inguinal hernia
- umbilical hernias: a bulge on your tummy near or below your belly button
- epigastric hernias: a bulge on your tummy, between your belly button and the lower part of your breastbone
If you have a hernia on each side of the tummy this is called a bilateral hernia.
There are 2 ways surgery can be carried out.
Open surgery can be done under general, spinal (epidural) or local anaesthetic. A cut (about 10cm long) is made so that the surgeon can see and access the muscle.
Keyhole (laparoscopic) surgery
Keyhole surgery is always done under general anaesthetic. The surgeon makes a small cut (about 1 or 2cm long) in, or just below, your belly button. A thin tube with a light and camera on the end (called a laparoscope) is put through the cut and passed down to your groin. The camera allows the surgeon to see inside your tummy.
The surgeon makes other small cuts to your tummy to repair the hernia. The surgeon uses special instruments to pull the bulge or lump back into your tummy and the hole is closed with a mesh patch.
We sometimes use robotic assistance with keyhole surgery. Your doctor will discuss if this is likely in your case.
Risks, complications and side effects
Most people recover well from hernia repair surgery and do not have complications but it is important to know what the possible complications are before you agree to proceed with surgery.
- Feeling sick (nausea). The anaesthetic can make you feel sick.
- Bleeding. More common if on blood thinning medicines.
- Difficulty having a wee (bladder retention). We will make sure you pass a good amount of urine before you go home. It is more common in patients who already have urinary or prostate problems. Sometimes a temporary catheter tube needs to be inserted.
- Pain and numbness. Some discomfort after surgery should be expected, but some patients will develop persistent pain and/or numbness in the groin after surgery. Many of these will improve with time. In smaller number of patients (1 in 20) this pain can be severe and require further treatment.
- Haematoma. A collection of blood under the wound or at the hernia site. Signs of this are swelling and tenderness This will often go away by itself but if the bleeding doesn't stop you might need an further operation to stop it.
- Seroma. A temporary build-up of fluid in the wound or groin area. This usually gets better without treatment.
- Infection. An infection inside the tummy or in the wound.
- Injury to blood vessels and organs. This is more common with keyhole surgery.
- Switching to open surgery. Your surgeon might start the operation using the keyhole method but then might need to cut open your groin part way through.
- Recurrence. As with any type of hernia repair, there is a risk that the hernia may come back in the future. This can happen in about 2 in 100 people.
Preparing for a hernia repair
It is important that you follow the instructions given to you by your doctor or nurse. If you do not, we may have to cancel your surgery. Please read more about our day surgery theatres.
If you have children or care for an adult, please make arrangements for someone else to help you with this after your surgery. If you think this will be a problem, please contact us before your surgery.
You will need someone to escort you home and stay with you for 24 hours after your surgery.
It is important that you stop smoking for at least 48 hours before your surgery to lower the risk of chest problems. Smoking can also delay healing because it reduces the amount of oxygen that goes to your wound. Coughing, caused by smoking, can interfere with the healing process.
We have a no-smoking policy at our hospitals. For your safety, we cannot allow you to leave the unit to smoke while you recover from your surgery.
Giving your consent (permission)
We want to involve you in decisions about your care and treatment. If you decide to go ahead, you will be asked to sign a consent form. This states that you agree to have the treatment and you understand what it involves.
If you would like more information about our consent process, please speak to a member of staff caring for you.
British Hernia Society provides a wide range of information.