Understanding Hernia Repair Options

What is a Hernia?

A hernia occurs when tissue or an organ pushes through a weak spot in the surrounding muscle or connective tissue, creating a noticeable bulge under the skin. Common sites for hernias include the groin (inguinal hernia), abdomen, or near previous surgical scars.
While small hernias may not cause immediate discomfort, most do not heal on their own and can gradually enlarge or become painful. Surgery is often recommended to prevent complications such as strangulation, where the blood supply to herniated tissue is cut off.

The two main surgical methods for repairing a hernia are open repair and laparoscopic (keyhole) repair. Both techniques are effective; the most suitable approach depends on the hernia’s size, type, and the patient’s overall health.

What is Open Hernia Repair?

In an open hernia repair, the surgeon makes a single incision directly over the hernia site to access the affected area. The protruding tissue is carefully repositioned, and the weakened muscle wall is reinforced with stitches or with a surgical mesh to reduce the risk of recurrence.

Open repair can be performed under local, regional, or general anaesthesia depending on the case. Patients typically go home the same day or after an overnight stay. Recovery usually takes a few weeks, during which patients are advised to avoid heavy lifting and strenuous activity.

Open surgery may be preferred when:

The hernia is large or complex.
The patient has had multiple abdominal surgeries.
Laparoscopic access is not suitable due to medical conditions or previous scar tissue.

What is Laparoscopic Hernia Repair?

Laparoscopic hernia repair, also known as keyhole surgery, uses small incisions to insert a camera and fine surgical instruments into the abdomen. The surgeon views the hernia on a magnified monitor and repairs it internally, usually reinforcing the muscle wall with mesh.

Because this technique uses small incisions, patients often experience:

Less post-operative discomfort.
Smaller scars.
A quicker return to daily activities compared to open surgery.

Laparoscopic repair is typically performed under general anaesthesia and may be particularly suitable for:

Bilateral (both-sided) hernias.
Patients who have recurrent hernias after an open repair.
Those who prefer a minimally invasive option with shorter downtime.

Comparing Open vs Laparoscopic Hernia Repair

Aspect	Open Surgery	Laparoscopic Surgery
Incisions	One larger incision	Three to four small incisions
View	Direct view of hernia site	Camera provides magnified internal view
Anaesthesia	Local, regional, or general	Usually general anaesthesia
Recovery time	Typically a few weeks	Often shorter, varies by patient
Suitable for	Large or complex hernias	Smaller, bilateral, or recurrent hernias

Both methods are safe and effective when performed by trained surgeons. The right choice depends on individual anatomy, type of hernia involved, and patient preferences.

How Long Does Hernia Surgery Take?

The duration of hernia surgery depends on the type of procedure, the hernia’s complexity, and whether it is performed as an open or laparoscopic (keyhole) repair.

In most cases, laparoscopic hernia repair takes about 45 minutes to 1 hour, while open hernia repair may take slightly longer, especially for larger or recurrent hernias. Both procedures are typically done as day surgeries, meaning patients can usually go home the same day after a short observation period.

More complex or recurrent hernias may require additional time in surgery and, occasionally, an overnight hospital stay for monitoring. During your consultation, the surgeon will discuss the expected duration, anaesthesia plan, and recovery timeline based on your individual condition.

Do All Hernias Require Surgery?

Not all hernias require immediate surgery, but most will eventually need surgical repair.
Small hernias that do not cause pain or restrict movement may be managed temporarily through watchful waiting, especially if the risk of complications is low. However, hernias typically do not heal on their own, and over time, the opening in the muscle wall may widen, causing the hernia to enlarge or become more uncomfortable.

Your doctor may recommend surgery if:

The hernia is increasing in size.
You experience pain, tenderness, or discomfort when standing or straining.
The hernia becomes difficult to push back in (incarcerated).
There are signs of obstruction or strangulation, such as severe pain, nausea, or vomiting.

Early evaluation helps determine whether surgical repair is necessary and allows for planning before complications arise.

How to Decide Which Method is Right for You

There is no single “best” technique for every patient. The decision should be based on a thorough evaluation by a surgeon experienced in both approaches.
Factors considered include:

The size and location of the hernia.
Patient’s age, overall health, and previous surgical history.
Recovery expectations and lifestyle needs.

A detailed consultation helps determine which method offers the safest and most effective outcome for each individual.

Comprehensive Hernia Care at KYM Surgery

At our hernia surgery clinic, we provide a full range of surgical options for hernia repair, including both open and laparoscopic techniques. Every treatment plan is personalised, taking into account the type of hernia, overall health condition, and long-term goals of the patient. We emphasise medical ethics, evidence-based care, and timely post-operative follow-ups to ensure a safe and smooth recovery process.

Frequently Asked Questions

1. Is laparoscopic hernia repair suitable for everyone?

Not always. Patients with very large or complicated hernias, or those who have undergone multiple abdominal surgeries, may be better suited for open repair.

2. Is surgical mesh always used?

In most cases, yes. Mesh helps reinforce the muscle wall and lowers the chance of recurrence. The type of mesh used will be discussed during your consultation.

3. Can a hernia come back after surgery?

Recurrence is uncommon but can happen. Following post-operative instructions and avoiding heavy strain during recovery helps reduce the risk.

4. How long is recovery after surgery?

Most patients resume light activities within a few days after laparoscopic surgery, or one to two weeks after open surgery. Full recovery times vary depending on individual healing and job requirements.

5. Are there any risks?

Like all surgical procedures, hernia repair carries some risks, including infection, bleeding, or recurrence. These are rare when surgery is performed by an experienced surgeon under proper sterile and safety protocols.

6. When should I seek urgent medical attention for a hernia?

You should seek immediate medical care if you experience: