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Surgery is usually needed to repair a hernia. During surgery, the surgeon will place the protruding intestine or tissue back into the abdominal wall. The muscles of the abdominal wall will then be strengthened by fixing a synthetic mesh to the muscles.

There are two ways that a hernia repair can be carried out:

• open surgery - where the surgeon will make a large incision in your abdomen, and
• laparoscopic (keyhole) surgery - where the surgeon will only make a very small incision in your abdomen, before using a specially designed camera and instruments to perform the surgery.

Advantages and disadvantages

Both types of surgery have advantages and disadvantages (see box). Open surgery usually has a longer recovery time and more post-operative pain than laparoscopic surgery, but unlike laparoscopic surgery, it can be carried out using a local anaesthetic.

This can be an important advantage for elderly people or those in bad health, because they may be too weak or frail to safely receive a general anaesthetic.

Although laparoscopic surgery tends to have a quicker recovery time and cause less post-operative pain, the risks of serious complications, such as the surgeon accidentally damaging the bowel, are higher than in open surgery.

A European Union study found that serious complications arose in approximately five out of every 1,000 cases of laparoscopic hernia surgery. In open hernia surgery, serious complications arose in only one out of every 1,000 cases.

In England, the number of surgeons who are trained to perform laparoscopic surgery is limited, so you may have to wait longer to receive treatment than if you opt for conventional open surgery.

You should discuss the advantages and disadvantages of both laparoscopic surgery and open surgery with your surgeon before deciding on the most appropriate treatment for you.

Hernia surgery is usually successful, but approximately 2% of people will experience a recurrence of the hernia and will require further surgery. Recurrence rates are broadly the same for both open and laparoscopic surgery.

Hernia trusses

In the past, people with hernias wore specially designed trusses to help keep their hernia in place. A truss is an elasticated belt that supports the abdomen and helps to prevent the hernia from protruding. However, trusses are no longer recommended because there is no evidence that they can help prevent a bowel obstruction or a strangulated hernia.

In some cases, your surgeon or GP may recommend that you wear a truss in the short-term while you are waiting for surgery.