Hernia repair

Hernias occur in the abdomen or groin and can affect both adults and children. There are different types, depending on their location and what caused it. Treating hernias is essential as they can potentially become life-threatening if left untreated.

At Guy’s and St Thomas’ Specialist Care, we offer expert-led hernia repair surgery for both adults and children. Our specialist gastrointestinal team has extensive experience in treating all types of hernia.

What is a hernia?

A hernia happens when an internal part of the body pushes through a weakness in the surrounding muscle or tissue wall. Usually, your muscles are tight enough to prevent this from happening. However, weak spots can develop for several reasons, allowing them to poke through.

Types of hernia

The most common type of hernia is an inguinal hernia – where a swelling or lump develops in your groin. The swelling can be painful and the lump will often appear when you try to lift something or lie down.

Other types of hernia include:

• femoral hernia – developing lower down than an inguinal hernia
• umbilical hernia – occurring near or below your belly button
• epigastric hernia – between your belly button and the lower part of your breastbone

Sometimes, you can push the lump back through the muscle wall, but it will poke out again once you release the pressure. If left untreated, hernias can grow larger and become more painful. Hernias will not disappear on their own and will require surgical repair.

Find out more about hernias in adults and children here.

How do I know if I need hernia treatment?

If you have a lump or bulge in any areas where a hernia can develop, you will need to book an appointment with a specialist. You might not need immediate treatment if your hernia is small and not causing you any problematic symptoms. However, hernias can worsen over time and potentially cause life-threatening complications, making a hernia repair necessary.

Our consultants will ask about your symptoms including any pain or feeling an aching or dragging sensation in your groin. If you’re diagnosed with a hernia, then surgery is needed.

Not all hernias will worsen over time, but there is no way of knowing this. So, having a hernia repair can be the right solution to futureproof your health.

Types of hernia surgery

There are different types of hernia surgery for adults and children.  The type of hernia surgery recommended will depend on your overall health and type of hernia.

Open surgery in adults

Surgeons typically perform open hernia repair in adults under general anaesthetic or a regional anaesthetic injected into your spine.

First, the surgeon makes an incision over the hernia to access it. Then they put the lump of fatty tissue or loop of your bowel (whichever caused the hernia) back into your stomach. The surgeon places a thin mesh in the weakened spot of your abdominal wall to prevent the hernia from returning.

Once the mesh is in place, they suture the incision and you will be taken to the recovery room.

Keyhole (laparoscopic) surgery in adults

For laparoscopic hernia repair, you will be under general anaesthetic, which means you will be asleep during the procedure.

First, the surgeon makes three tiny incisions into your abdomen and inserts a thin tube with a light and camera attached (a laparoscope) into one. Next, they insert surgical instruments into the other two incisions, allowing them to pull back the hernia into place.

There are two different types of laparoscopic hernia repair:

Transabdominal preperitoneal laparoscopic surgery (TAPP)

Surgical instruments are inserted through the muscle wall in your abdomen and into the lining that covers your organs (the peritoneum). The surgeon moves a small flap of your peritoneum back over the hernia to fix a piece of mesh into the weakened areas of your muscle wall.

Totally extraperitoneal laparoscopic surgery (TEP)

This keyhole surgical technique repairs your hernia without entering the peritoneal cavity (the membrane that lines the inside of your abdomen and pelvis). Surgeons use mesh to strengthen the muscle wall and repair the hernia.

Open surgery in children

In children, umbilical and epigastric hernias would be carried out using open surgery under general anaesthetic. During the procedure your child will be asleep, and the surgeon will make a cut either within the tummy button or directly over the bulge of the hernia.

Inguinal hernia surgery in children can be carried out either via open surgery through a small cut over the bulge of the hernia or with keyhole surgery – both are carried out under general anaesthetic. The choice will depend on your surgeon’s preference, the age of the child and the size of the hernia.

Inguinal hernia surgery in children is different to adults. In most cases a simple suture repair can be carried out, however in some rarer cases mesh may be inserted to repair the hernia.

Recovery from hernia repair surgery

How quickly you recover following hernia repair surgery depends on a range of factors, including the type and complexity of the procedure, as well as the type of hernia you have.

Typically, most people can return to work within a few days, depending on whether their job is not physically demanding (such as a desk job). It may be a few weeks if your job requires you to lift things.

You will be able to take part in light exercise, like walking, the day after your procedure, gradually increasing your activity level as you heal.

Speak to your doctor about the best timeline based on your work and overall health.

Which type of hernia surgery is right for me?

If you think you or your child may have a hernia and are unsure which type of repair is best, don’t hesitate to speak with one of our highly skilled specialists. They can guide you through different options so you can make the right choice for your health.

Benefits of hernia repair

Hernia repair surgery is considered a safe procedure and can prevent the problem from returning in future, with open surgery having a slightly lower risk of the hernia returning than keyhole surgery.

However, a keyhole procedure causes less scarring than open surgery, and is usually associated with a faster recovery and less pain experienced.

Your surgeon will explain the benefits of the hernia repair procedure they recommend, including likely surgical outcomes.

Risks of a hernia repair

All surgical procedures carry some possible risks. The potential risks associated with hernia repair can include:

• accidental damage to your bowel during surgery (this is more common in laparoscopic surgery)
• infection
• allergic reactions to the anaesthetic used
• seroma (a temporary build-up of fluid in your wound)
• recurrent hernias

Sometimes, you may opt for laparoscopic surgery but end up having open surgery part of the way through. This switch in surgical technique can be for many reasons, but surgeons will only do it for the betterment and protection of your health.

Hernia repairs are an essential surgery for your health and to ensure your hernia does not get worse. When you choose Guy’s and St Thomas’ Specialist Care for your hernia repair, you can be sure you are in the hands of the experts.