Neyyar Medicity

Neyyar Centre for Hernia

Surgeries and Procedures

What is a hernia ?

A hernia is a bulge over the abdominal wall caused by a weakness or tear of the muscles which allows organs such as the intestines, fatty tissue inside the abdomen and urinary bladder to protrude through the defect. Patients usually notice a swelling under the skin and may experience pain and discomfort occasionally. Symptoms may worsen after prolonged standing, walking or straining (e.g. lifting of heavy objects).

Most hernias occur as a result of weakness or defect in the muscles of the abdomen since birth. As one ages, this defect is further weakened by strenuous physical activity, lifting of heavy objects or incisions of a previous surgery.

The risk of developing a hernia increases with:

Types Of Hernia

Hernias are named according to their location on the abdominal wall or occasionally their specific cause.


Most patients notice a bulge over the abdomen. Some patients may experience pain over the swelling particularly while straining, and/or during physical activity. Most hernias are diagnosed by routine clinical examinations. In some cases, an ultrasound or a CT scan can be performed

Most hernias need to be repaired surgically to treat symptoms and prevent complications (e.g. strangulation of intestine). Truss or abdominal binder are just temporary measures while awaiting surgery.

The only treatment for hernia is surgery to repair the defect in the muscle. By not undergoing surgery, the hernia may increase in size and a portion of the intestine or fat inside the abdomen may pass through the defect and get trapped. This may lead to blockage or strangulation of the intestine. Patients may also get a sudden onset of abdominal pain, distention of abdomen, persistent vomiting and constipation.

Most hernias are operated under General Anaesthesia (GA). Local Anaesthesia (LA) can also be an option for patients who are not suitable for GA.

Most patients go home on the same day. Few patients stay overnight for pain or social/familial reasons. Patients with large or complex hernia may have to be warded for a few days, depending on the complexity of the surgery.

Inguinal Hernia Surgery

Open Hernia Repair

Done from an 8-10cm incision in the groin, the hernia is reduced and the defect in the muscles is repaired with a surgical prosthesis (mesh). For bilateral hernia, incisions on both groins are needed. This can be performed under LA.

Laparoscopic (Keyhole) Surgery

A laparoscope (tiny camera) and small instruments are inserted through 3 small holes into the abdomen. The hernia is then identified, reduced, and repaired with a mesh.This is usually carried out under GA. 2 types of Laparoscopic Surgery:

1. TAPP (Trans abdominal pre-peritoneal)
2.TEP (Totally extra-peritoneal)

Why Keyhole surgery?

Ventral Hernia Surgery

Open Mesh Repair

The skin incision depends on the size of the hernia, and is almost two to three times the size of the hernia. The hernia is pushed back and the defect in the muscle is closed with sutures. This is then covered by a mesh which is fixed to the abdominal wall with multiple stiches. For large hernias, we may need to place plastic tubes (drain) through the abdominal wall for a few days.

Laparoscopic (Keyhole) Surgery

A 1012mm incision is made at the flank and two additional 5mm incisions above and below the first cut, usually on one side of the abdomen. A tiny camera allows the surgeon to see the surgery on a TV screen and thin long instruments are also inserted through these cuts. The hernia is reduced back inside the abdomen, and the defect is closed with stitches and covered by a mesh from inside. This mesh is fixed to the abdominal wall with a few stiches and absorbable screw-like device (tackers).

Why Keyhole surgery?


Dr Vijin V

Senior Consultant Laparoscopic and Robotic Surgeon International Hernia Trainer