Hernia surgery in Australia is performed hundreds of thousands of times each year, making hernia repair one of the most frequently undertaken general surgical procedures in the country.
Yet despite how common it is, most people who are diagnosed with a hernia have significant questions about whether they need surgery, how urgent it is, and what recovery will look like.
The answers depend on the type of hernia, its size, your symptoms, and your overall health. Here is what you need to know to make sense of your diagnosis and your options.
The Royal Australasian College of Surgeons provides guidance on hernia management and can help you locate a fellowship-trained general surgeon for your consultation.
What a Hernia Actually Is
A hernia occurs when an internal organ or tissue pushes through a weakness or gap in the surrounding muscle or connective tissue wall. The result is a bulge that may be visible or palpable, often more prominent when standing, coughing, or straining.
Hernias do not heal on their own. The weakness in the wall does not repair itself, and hernias typically enlarge over time.
The main risk associated with a hernia is incarceration, where the hernia contents become trapped and cannot be pushed back, and strangulation, where the blood supply to the trapped tissue is cut off. Strangulated hernias are surgical emergencies.
The Most Common Types of Hernia in Australia
Inguinal hernia is by far the most common type, accounting for the majority of hernia repairs performed in Australia.
It occurs in the groin area where the inguinal canal, a passage through the abdominal wall, creates a natural point of weakness. Inguinal hernias are significantly more common in men than women due to anatomical differences.
Femoral hernia occurs just below the inguinal ligament in the upper thigh and is more common in women. Femoral hernias carry a higher risk of strangulation than inguinal hernias and are typically repaired promptly after diagnosis.
Umbilical hernia occurs through or near the belly button and is common in infants, where it usually resolves on its own. In adults, umbilical hernias are caused by increased abdominal pressure from obesity, pregnancy, or heavy lifting and generally require surgical repair.
Incisional hernia develops through a previous surgical incision site where the abdominal wall has been weakened by a prior operation. These can occur months to years after the original surgery and vary widely in size and complexity.
Hiatal hernia involves part of the stomach pushing up through the diaphragm into the chest cavity. Unlike other hernias, it is not visible externally and is managed differently, often with medication for reflux symptoms, with surgery reserved for specific indications.
Watchful Waiting vs Surgery
Not every hernia requires immediate surgery. For asymptomatic or minimally symptomatic inguinal hernias in men, research has shown that watchful waiting is a safe option in the short term, with surgery deferred until symptoms develop or worsen.
However, most hernias do eventually become symptomatic and require repair. Waiting until a hernia is large and symptomatic can make surgery more complex.
And for femoral hernias, umbilical hernias in adults, and any hernia causing significant discomfort or with a narrow neck, earlier repair is generally recommended due to higher complication risk.
Your surgeon will advise the appropriate approach based on your specific hernia characteristics and circumstances.
How Hernia Surgery Is Performed
Hernia repair can be performed using an open or laparoscopic approach, and both can be done with or without mesh.
Open hernia repair involves a direct incision over the hernia, reduction of the hernia contents back into the abdomen, and closure of the defect, usually reinforced with a synthetic mesh to reduce recurrence rates. It is a reliable technique with a long track record.
Laparoscopic hernia repair involves three small keyhole incisions and repair of the defect from inside the abdomen, again typically with mesh placement. Recovery is generally faster and post-operative pain is less than with open surgery.
Laparoscopic repair is particularly well-suited to bilateral inguinal hernias, where both groins are repaired through the same three incisions, and for recurrent hernias.
Mesh use in hernia repair significantly reduces recurrence rates compared to direct tissue repair alone and is the standard approach for most adults. In specific situations, such as small umbilical hernias or hernias in young patients, primary repair without mesh may be appropriate.
Recovery After Hernia Surgery
Recovery depends on the type of hernia repaired, the surgical approach used, and the patient’s overall health.
For laparoscopic inguinal hernia repair, most patients return to light activities and desk work within one to two weeks. Return to physical labour or heavy lifting typically takes four to six weeks. Open repair of larger or more complex hernias may require a longer recovery.
Pain in the first few days is well managed with oral medications. Groin discomfort, a sensation of pulling, and mild swelling around the repair site are normal in the early weeks.
Chronic groin pain following inguinal hernia repair affects a small proportion of patients and is an important outcome to discuss with your surgeon.
Continence Foundation of Australia provides information relevant to patients who experience pelvic floor issues in connection with hernia or post-surgical symptoms.
Risks of Hernia Surgery
Hernia repair is generally safe but carries risks that are worth understanding. Recurrence of the hernia is the most common long-term concern, with rates depending on hernia type, repair technique, and patient factors.
Wound infection, bleeding, and injury to adjacent structures including nerves, blood vessels, or the vas deferens in men are recognised complications.
Chronic pain is the most significant quality-of-life concern following inguinal hernia repair and occurs in a small percentage of patients.
Conclusion
Hernia surgery in Australia is a common and effective operation that resolves symptoms and prevents serious complications for the majority of patients. The right timing and approach depend on your individual situation, and a consultation with an experienced general surgeon is the best way to get personalised guidance.
If you have a known hernia that is causing symptoms or have recently been diagnosed and want to understand your options, getting a surgical opinion early gives you the most choices.
FAQs
1. Is hernia surgery covered by Medicare in Australia?
Yes. Hernia repair attracts Medicare rebates. Private hospital and anaesthesia costs may result in out-of-pocket expenses depending on your private health insurance. The public system can perform hernia repairs but waiting times for elective procedures vary by state and urgency.
2. Can a hernia repair itself without surgery?
No. Hernias do not heal spontaneously. A hernia support garment or truss may provide temporary symptom relief but does not treat the underlying defect. Surgery is the only definitive treatment.
3. What happens if a hernia is left untreated?
Most hernias enlarge over time. The main risks of leaving a hernia untreated are incarceration, where the hernia contents become trapped, and strangulation, where the blood supply is cut off. Both are surgical emergencies. The risk of these complications varies by hernia type and is higher for femoral hernias.
4. How soon can I return to the gym after hernia surgery?
Light exercise including walking can usually begin within a few days of surgery. Return to gym-based exercise and resistance training typically takes four to six weeks depending on the type of repair and your surgeon’s instructions. Returning too soon risks recurrence.
5. Can hernias be prevented?
While hernias cannot always be prevented, maintaining a healthy weight, avoiding chronic constipation and straining, using proper lifting technique, and treating persistent cough reduces the risk of developing or worsening a hernia. People with a family history of hernias may be at higher inherent risk regardless of lifestyle factors.