Types of Hernia

Hernia TypeDescriptionStandard Treatment
Inguinal (groin)Most common (75% of abdominal hernias); predominantly in men; groin/scrotum bulgeLaparoscopic or open mesh repair
Femoral (inner thigh/groin)More common in women; higher strangulation risk; prompt repair recommendedLaparoscopic TEP/TAPP or open
Umbilical (navel)Protrusion through umbilical ring; common in infants (usually self-resolves) and obese adultsRepair if symptomatic or >2cm in adults
Epigastric (upper midline)Fatty tissue through midline above navel; often small; may cause painOpen or laparoscopic repair
Incisional (at surgical scar)Weakness at previous abdominal surgery site; risk increases with obesity, infectionLaparoscopic or open mesh repair
Sports hernia (athletic pubalgia)Injury to inguinal region in athletes; microscopic tear, no obvious bulgeSports rehabilitation ± surgery

Laparoscopic vs Open Hernia Repair

TechniqueDescriptionNotes
Laparoscopic TEP3 small incisions; mesh placed extraperitoneally; no abdominal entry; preferred for bilateralFaster recovery; bilateral in single operation
Laparoscopic TAPP3 incisions; enters abdominal cavity; good view; flexible for recurrent/complex herniasSlightly longer recovery than TEP; better for recurrent cases
Open (Lichtenstein) Mesh Repair2–4cm groin incision; flat mesh placed; local or spinal anaesthesia possibleCheaper; suitable for high-risk surgical patients
Robotic Hernia RepairRobot-assisted laparoscopic approach; similar outcomes to standard laparoscopic; higher cost$20,000–$35,000; for complex cases

Emergency Hernia: Strangulation

A strangulated hernia occurs when the blood supply to the herniated tissue is cut off — a surgical emergency. Symptoms: severe, sudden pain at the hernia site, hernia becomes hard and cannot be pushed back in, nausea/vomiting, fever. Go to A&E immediately. Emergency surgery has higher complication rates than elective repair — this is why all symptomatic hernias should be repaired electively before becoming an emergency.

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Inguinal (groin) hernias are by far the most common, accounting for 75% of all abdominal hernias. They are far more common in men (lifetime risk 27% vs 3% in women). Other types: femoral hernia (groin, more common in women), umbilical hernia (navel), epigastric hernia (midline above navel), and incisional hernia (at a previous surgical scar site).

Not immediately. Watchful waiting is acceptable for small, asymptomatic inguinal hernias in men — annual risk of acute complications (strangulation) is 0.3–3%. However, all hernias that become symptomatic (pain, discomfort, size increase) should be repaired. All femoral hernias should be repaired promptly due to high strangulation risk. Irreducible hernias (cannot be pushed back in) or strangulated hernias (blood supply cut off — emergency) require urgent surgery.

Laparoscopic (keyhole) hernia repair uses 3 small incisions (0.5–1cm) and a camera to repair the hernia defect from inside with a mesh. The main techniques are TAPP (transabdominal preperitoneal) and TEP (totally extraperitoneal). Advantages: less pain, faster recovery (back to work in 1–2 weeks vs 3–4 weeks for open), less wound complications, and better for bilateral or recurrent hernias. The mesh provides lasting reinforcement.

Laparoscopic hernia repair at a private hospital: $8,000–$18,000 (unilateral); $12,000–$22,000 (bilateral). Open hernia repair: $5,000–$12,000. All hernia surgeries are Medisave and MediShield Life claimable. IP insurance covers most costs subject to deductible. Public hospital rates are significantly lower with subsidy.

Laparoscopic repair: Most patients return to light office work in 1–2 weeks. Heavy lifting and strenuous activity should be avoided for 4–6 weeks. Open repair: 2–3 weeks for desk work; 6–8 weeks for heavy activity. Mesh repairs have lower recurrence rates (1–3%) than repairs without mesh (10–15%). Post-operative pain is generally mild and controlled with oral analgesics.