Incisional hernia repair

• Infection at the original wound
• Heavy lifting too soon after surgery
• Chronic coughing
• Obesity
• Smoking
• Diabetes
• Multiple abdominal surgeries.

If you feel pain around a scar or in the surrounding abdomen or feel a soft bulge that becomes uncomfortable with movement or pressure, then you may want to consider incisional hernia repair surgery, also known as herniorrhaphy (when stitches are used) or hernioplasty (when mesh is used). Our expert surgeons at Nuffield Health aim to remove the hernia and ease discomfort.

How fast does an incisional hernia grow?

The growth of an incisional hernia can vary. Some remain small for years while others enlarge gradually due to pressure from coughing, lifting, pregnancy or weight gain.

How is an incisional hernia diagnosed?

• Ultrasound: This can be helpful for small or unclear hernias.
• CT scan: Often used for complex or unclear cases.
• MRI: Is used occasionally.

What are the signs that an incisional hernia has become strangulated?

• Severe or worsening pain
• A lump that becomes hard or cannot be pushed back in
• Redness or tenderness over the hernia
• Vomiting or nausea
• Fever.

These symptoms may indicate a strangulated hernia.

Why do incisional hernias develop after surgery?

The healing process can be affected by tension on the wound, infection, poor tissue strength or increased abdominal pressure.

Can a C-section cause an incisional hernia?

Yes. Any abdominal incision, including a C‑section, can lead to an incisional hernia if the area doesn’t heal strongly.

What happens if an incisional hernia is left untreated?

If left untreated, an incisional hernia may become enlarged, painful or trapped (incarcerated). If the blood supply to the herniated tissue is cut off (strangulation), urgent surgery is required. A hernia strangulation can be life‑threatening if not treated quickly.

What are the symptoms of an incisional hernia?

• A lump near a surgical scar
• Discomfort when lifting or coughing
• A dragging or heavy sensation
• Pain that worsens with activity
• Bloating or constipation (in larger hernias).

What surgical techniques are used to repair an incisional hernia?

Open incisional hernia repair
Your surgeon makes a larger cut over the hernia, returns the tissue to the abdomen and strengthens the area with stitches or mesh. This approach is often used for bigger or more complex hernias.

Laparoscopic (keyhole) incisional hernia repair
Several smaller cuts are made in the abdomen. The area is gently inflated with gas so your surgeon can see clearly, and mesh is placed over the weak spot from the inside. This approach often results in less pain and quicker recovery.

Component Separation Technique (CST)
CST is used for large or difficult hernias. The abdominal muscles are carefully separated and repositioned so the hernia can be closed without pulling or tension.

Recurrent incisional hernia repair
If a hernia comes back, it can still be repaired using open, keyhole or CST techniques. Your surgeon will choose the safest approach based on your previous surgery and the size of the recurrence.

Open hernia repair, keyhole vs CST hernia repair: which surgery is right for me?

• The size of your hernia
• The location of your hernia
• Whether you’ve had any previous surgeries
• Your general health
• The risk of recurrence.

Keyhole surgery may offer faster recovery, but open or CST repair may be safer for large or complex hernias.

How do I know if I need incisional hernia repair?

• Painful
• Growing in size
• Affecting daily life
• At risk of becoming trapped.

Who is suitable for incisional hernia repair?

Most adults with an incisional hernia are suitable. Your consultant will assess your overall health and anaesthetic risk.

Who is not suitable for incisional hernia repair?

Surgery may be delayed if you have uncontrolled medical conditions or a high anaesthetic risk.

Can I have incisional hernia repair if I am overweight?

Yes, you can, but weight loss may be recommended first to reduce recurrence risk.

Can I have incisional hernia repair if I am pregnant?

If you’re planning pregnancy, your surgeon may advise delaying surgery unless the hernia is causing problems.

What are the alternatives to incisional hernia repair?

There are no long‑term alternatives. A hernia truss or support belt may offer temporary comfort but they do not repair the hernia.

What is watchful waiting for an incisional hernia?

This means monitoring the hernia without surgery. It’s sometimes appropriate for small, painless hernias but carries a risk of complications.

How can I prepare for incisional hernia repair?

• Stop smoking
• Maintain a healthy weight
• Avoid heavy lifting
• Shower the day before or on the day of surgery
• Avoid shaving the surgical area
• Keep blood sugar levels controlled if diabetic
• Tell your team about all medications.

These steps can help to reduce infection risk and support your recovery.

What happens at the pre-operative assessment?

You’ll meet your healthcare team to review your medical history, discuss anaesthetic options and plan your recovery. You may have blood tests and will receive instructions about fasting and medication.

What happens during incisional hernia repair?

The procedure is usually performed under general anaesthetic and can take several hours.

1. A small incision is made near the belly button
2. The abdomen is inflated with carbon dioxide
3. Additional small incisions allow instruments and a camera to be inserted
4. The hernia is freed and mesh is placed over the defect
5. The incisions are closed with stitches or glue.

A drain may be placed to remove fluid.

During open repair
Your surgeon makes a cut through the old scar, repairs the weak tissue with stitches or mesh and closes the skin. Drains may be left in place for several days or weeks depending on the size of the hernia.

How long does it take to recover from incisional hernia repair?

Short‑term recovery
You may go home the same day or stay one night. Pain relief will be provided – it’s important to take it so you can move comfortably.

Shoulder pain is common after keyhole surgery due to gas under the diaphragm; this settles within 24 hours.

• It’s best to have someone stay with you
• Do not drive, operate machinery, drink alcohol and sign legal documents

• Gentle walking regularly from day one
• Avoid strenuous exercise for at least 3 weeks
• Avoid heavy lifting (anything heavier than a kettle) for at least 6 weeks to allow the muscle wall and mesh to heal strongly
• Full return to fitness, e.g., jogging, weight-lifting at 8-12 weeks
• Avoid baths, pools and hot tubs for 2 weeks
• Shower after 48 hours.

Driving and work
You can drive once you can safely control your vehicle. Most patients return to work after 2–4 weeks – depending on the nature of your job, this may vary. It’s best to discuss a suitable timeframe with your surgeon.

What are the risks and complications of incisional hernia repair?

Every surgical procedure can carry risks. Be sure to discuss any concerns you might have about these risks with your surgeon.

• Pain
• Bleeding
• Infection
• Blood clots
• Scarring.

• Injury to internal organs
• Bowel injury
• Fluid or blood collections (seroma or haematoma) which can feel like a temporary lump at the surgical site
• Testicular discomfort (in men)
• Difficulty passing urine
• Mesh‑related complications
• Hernia recurrence.

• Bruising
• Swelling
• Shoulder pain after keyhole surgery
• Temporary bloating.

• Worsening pain
• Fever
• Dizziness or shortness of breath
• Nausea that worsens after 1–2 days
• No bowel movements or wind
• Abdominal swelling
• Difficulty passing urine.

How much does incisional hernia repair surgery cost at Nuffield Health?