Hernias are a common medical condition that can affect people of all ages, often causing discomfort and, in some cases, severe complications if left untreated. While not always immediately life-threatening, hernias rarely heal on their own, and surgery is often the most effective solution to repair the affected area and prevent recurrence. Understanding how hernias develop, recognising their symptoms, and learning about available treatment options can help patients make informed decisions about their care.

Specialists such as Dr Roshan Ariyaratnam, a leading general surgeon in Australia, emphasise the importance of early diagnosis and timely intervention to achieve the best outcomes for hernia patients. With advances in surgical techniques and technology, hernia repair has become safer, more efficient, and less invasive than ever before.
What Is a Hernia?
A hernia occurs when an internal organ or tissue pushes through a weak spot in the surrounding muscle or connective tissue. This protrusion creates a visible or palpable bulge, often accompanied by discomfort or pain. Hernias can develop in various parts of the body, but they most commonly occur in the abdomen, where the muscular wall has areas of natural weakness.
There are several types of hernias, each classified according to their location and underlying cause:
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Inguinal hernia: Found in the groin area, inguinal hernias are the most common type, especially among men.
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Femoral hernia: Similar to inguinal hernias but located slightly lower in the groin, more common in women.
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Umbilical hernia: Occurs near the belly button and often affects infants, though adults can also develop them due to pressure on the abdominal wall.
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Hiatal hernia: Occurs when part of the stomach pushes through the diaphragm into the chest cavity.
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Incisional hernia: Develops through a scar from previous abdominal surgery.
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Epigastric and Spigelian hernias: Less common types, occurring in specific areas of the abdominal wall.
Causes and Risk Factors
Hernias usually result from a combination of muscle weakness and strain. Some people are born with weak abdominal muscles, while others develop weakness over time due to ageing, injury, or lifestyle factors. The primary causes and contributing risk factors include:
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Heavy lifting: Frequent lifting of heavy objects without proper technique increases intra-abdominal pressure and strains the abdominal wall.
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Chronic coughing or sneezing: Persistent respiratory conditions can gradually weaken the muscles.
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Constipation: Straining during bowel movements places pressure on the abdomen.
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Pregnancy: The growing uterus stretches and weakens abdominal muscles.
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Obesity: Excess body weight adds constant pressure to the abdominal wall.
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Previous surgeries: Surgical incisions can create weak spots where hernias may later develop.
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Ageing: As people age, muscles naturally lose strength and elasticity.
Hernias can develop suddenly, such as after lifting something heavy, or gradually, as muscle weakness increases over time. Certain occupations, like manual labour or jobs requiring repetitive physical effort, can increase the risk.
Recognising the Symptoms
The most common sign of a hernia is a noticeable lump or bulge under the skin, especially when standing or straining. However, symptoms can vary depending on the type and severity of the hernia.
Typical symptoms include:
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A visible bulge that may disappear when lying down.
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Pain or discomfort in the affected area, particularly during lifting, bending, or coughing.
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A feeling of heaviness or pressure in the abdomen.
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Burning or aching sensations at the hernia site.
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Weakness or tightness in the abdominal wall.
In some cases, a hernia can become incarcerated or strangulated, meaning the protruding tissue becomes trapped and its blood supply is cut off. This is a medical emergency requiring immediate surgery. Symptoms of a strangulated hernia include sudden severe pain, nausea, vomiting, fever, and a tender or discoloured bulge. Prompt treatment is essential to prevent serious complications.
Diagnosing a Hernia
Diagnosis typically begins with a physical examination, during which a doctor may ask the patient to stand, cough, or strain to observe the bulge more clearly. Depending on the hernia’s location or complexity, imaging tests such as ultrasound, CT scans, or MRI scans may be ordered to confirm the diagnosis and assess the extent of the protrusion.
Accurate diagnosis allows the surgeon to recommend the most suitable treatment plan, taking into account the hernia’s size, location, and the patient’s overall health.

Treatment Options
The management of a hernia depends on its type, severity, and the patient’s symptoms. While small, painless hernias may be monitored initially, surgery is generally recommended for most cases to prevent enlargement and complications.
1. Watchful Waiting
For patients with small, asymptomatic hernias, a “watch and wait” approach may be appropriate. Regular medical reviews are essential to monitor any changes. However, delaying surgery can increase the risk of incarceration or strangulation, so medical supervision is crucial.
2. Surgical Repair
Surgery is the definitive treatment for hernias. The goal of hernia surgery is to return the displaced tissue to its correct position and strengthen the weakened area of the muscle wall.
There are two main types of hernia surgery:
Open Hernia Repair
In open surgery, the surgeon makes a single incision near the hernia site. The protruding tissue is repositioned, and the weakened muscle is reinforced, often with the use of a synthetic mesh to reduce recurrence risk. This approach is typically used for larger or more complex hernias and may require a slightly longer recovery period.
Laparoscopic (Keyhole) Repair
Laparoscopic surgery is minimally invasive, using small incisions and specialised instruments guided by a camera. This technique offers several benefits, including smaller scars, reduced pain, and faster recovery times. Patients can often return to normal activities within a few weeks. Not all hernias are suitable for laparoscopic repair, and the choice depends on the type of hernia and the patient’s medical history.
Renowned surgeons like Dr Roshan Ariyaratnam highlight that advancements in laparoscopic and robotic-assisted procedures have revolutionised hernia surgery. These innovations allow for greater precision, reduced complications, and quicker patient recovery — key advantages for both patients and healthcare systems.
Robotic Hernia Repair
This advanced technique combines the benefits of laparoscopic surgery with robotic technology, giving the surgeon enhanced dexterity and control. It is particularly effective for complex or recurrent hernias.
Recovery and Aftercare
Recovery after hernia surgery varies based on the type of procedure and the individual’s overall health. Most patients can go home on the same day or within 24 hours. Discomfort is normal for the first few days, but pain is usually well controlled with prescribed medication.
General recovery guidelines include:
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Rest and gradual movement: Light activity helps prevent blood clots, but heavy lifting and strenuous exercise should be avoided for several weeks.
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Wound care: Keeping the surgical site clean and dry reduces infection risk.
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Diet: A high-fibre diet and adequate hydration help prevent constipation, which can strain the surgical site.
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Follow-up appointments: Regular check-ups allow the surgeon to monitor healing and ensure there are no complications.
Patients are typically advised to resume normal activities gradually, depending on their comfort level and the type of work they do. Most return to light duties within two to three weeks, while full recovery may take up to six weeks for more extensive repairs.
Possible Complications
While hernia surgery is generally safe, all surgical procedures carry some risks. Potential complications include infection, bleeding, recurrence of the hernia, nerve pain, or reactions to anaesthesia. The use of surgical mesh has significantly reduced recurrence rates, but mesh-related complications, though rare, can occur.
Selecting an experienced surgeon, following pre-operative advice, and adhering to post-operative care instructions are the best ways to minimise these risks.
Preventing Hernias
Although not all hernias can be prevented, especially those caused by genetic or congenital weakness, several lifestyle changes can lower the risk:
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Maintain a healthy body weight to reduce pressure on abdominal muscles.
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Practise proper lifting techniques — use the legs rather than the back and avoid sudden, jerky movements.
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Strengthen core muscles with regular exercise.
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Avoid constipation by consuming a high-fibre diet.
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Quit smoking to reduce chronic coughing.
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Manage conditions such as asthma or chronic obstructive pulmonary disease (COPD) that cause persistent coughing.
These preventive steps can also help avoid recurrence after hernia repair surgery.
The Importance of Early Intervention
Ignoring a hernia or postponing surgery can lead to severe complications, such as obstruction or strangulation, which require emergency surgery. Early consultation with a qualified general surgeon allows for accurate diagnosis and a tailored treatment plan. Modern surgical techniques, combined with skilled care, ensure that hernia repair is a safe and effective procedure with excellent long-term outcomes.
Hernia surgery has evolved significantly, offering patients a range of options from traditional open repair to advanced minimally invasive procedures. Understanding the causes, recognising symptoms early, and seeking timely medical advice are essential steps towards effective treatment and recovery. With the expertise of trained professionals and continued advancements in surgical technology, hernia repair today offers faster healing, minimal discomfort, and improved quality of life for patients.
For anyone experiencing the symptoms of a hernia, prompt assessment by a qualified general surgeon is the best way to ensure a safe and lasting recovery. Early treatment not only prevents complications but also allows individuals to return to their daily activities with renewed comfort and confidence.











