A LUMP OR BULGE
A bulge in the groin, at the navel or along a previous surgical incision.
BACK TO SERVICESCONTEMPORARY HERNIA REPAIR
HERNIA SURGERY
Individualised repair of groin and abdominal-wall hernias, using laparoscopic or open techniques according to anatomy.
TAPP / TEPABDOMINAL WALLSCOLA
EXPLORE THE PROCEDURESELIXIS · ADVANCED CARE
The technique follows the hernia — not the other way round
Site, size, previous surgery, tissue quality and daily demands determine the access and mesh plane.
SYMPTOMS
Symptoms that merit assessment
A hernia occurs when fat or bowel protrudes through a weak point in the abdominal wall. It may cause almost no symptoms or become more noticeable as abdominal pressure rises.
PAIN OR BURNING
Pain, burning, heaviness or a pulling sensation around the hernia.
WITH STRAIN
Symptoms may increase with coughing, lifting, exercise or prolonged standing.
WHEN LYING DOWN
The bulge often becomes smaller and discomfort improves when lying down.
CHANGE IN SIZE
The swelling may become more obvious later in the day or during activity.
SCROTAL EXTENSION
Some large inguinal hernias extend into the scrotum and cause heaviness or difficulty.
Not every lump is a hernia and size alone does not define severity. Diagnosis is based on examination and selected imaging when needed.
PROCEDURES
The main procedures
Each procedure addresses a different anatomical problem. The indication and choice of material are determined after clinical assessment.
01TAPP
LAPAROSCOPIC TAPP INGUINAL REPAIR
Transabdominal access to the preperitoneal plane with broad coverage of the myopectineal orifice.
- WHEN IT MAY BE CONSIDERED
- Unilateral or bilateral groin hernia and selected recurrences.
- WHAT IT INVOLVES
- Reduction, anatomical dissection, flat mesh placement and peritoneal closure.
02TEP
EXTRAPERITONEAL TEP
Repair within the preperitoneal plane without entering the peritoneal cavity.
- WHEN IT MAY BE CONSIDERED
- Selected primary or bilateral inguinal hernias.
- WHAT IT INVOLVES
- Creation of the extraperitoneal plane, identification of defects and mesh coverage.
03COMPLEX TAPP
LARGE INGUINOSCROTAL HERNIA WITH TAPP
An advanced laparoscopic approach for selected large hernias extending into the scrotum.
- WHEN IT MAY BE CONSIDERED
- Large or complex inguinoscrotal hernia after careful planning, in an appropriate patient and by a team experienced in this anatomy.
- WHAT IT INVOLVES
- Controlled sac reduction and broad preperitoneal reinforcement. Conversion may be required for safety; seroma and uncommon spermatic-cord or testicular complications are discussed beforehand.
04VENTRAL
UMBILICAL & VENTRAL HERNIA
Laparoscopic or hybrid repair of an abdominal-wall defect through small access points.
- WHEN IT MAY BE CONSIDERED
- Symptomatic umbilical or primary ventral hernia of suitable size.
- WHAT IT INVOLVES
- Reduction, defect closure when appropriate and reinforcement in the selected anatomical plane.
05INCISIONAL
INCISIONAL HERNIA REPAIR
Reconstruction of a hernia at a previous incision, accounting for adhesions and abdominal-wall quality.
- WHEN IT MAY BE CONSIDERED
- Symptomatic or enlarging incisional hernia.
- WHAT IT INVOLVES
- Careful adhesiolysis, functional midline reconstruction and individualised reinforcement.
06SCOLA
LINEA-ALBA HERNIA & DIASTASIS
SCOLA combines repair of a small midline hernia and rectus diastasis. It is an evolving technique with limited long-term comparative evidence.
- WHEN IT MAY BE CONSIDERED
- Selected small midline hernias with diastasis, after considering weight, symptoms and future pregnancy plans.
- WHAT IT INVOLVES
- Small low incisions, endoscopic diastasis plication and onlay reinforcement. It is not scar-free; seroma, wound or mesh complications and recurrence are discussed.
Conceptual anatomical artwork for general information — not a patient photograph or an exact representation of an operation.
PLANNING & SAFETY
Anatomical precision and durable repair
Success is determined not only by incision size, but also by the indication, adequate defect coverage and careful protection of nerves, vessels and viscera.
MAPPING
Clinical examination and imaging when required.
PLANE SELECTION
Mesh is placed in the appropriate anatomical plane.
FUNCTION
The aim is abdominal-wall function, not merely closing a hole.
FOLLOW-UP
A staged return to lifting and exercise with clear guidance.
QUESTIONS
FREQUENTLY ASKED QUESTIONS
Short answers before an individualised surgical assessment.
01Is a minimally invasive approach always possible?
No. It is chosen when safe and meaningfully beneficial. Anatomy, previous surgery and complexity may require another approach or conversion.
02How long does recovery take?
Recovery varies with the procedure, disease severity and general health. The individual plan covers mobilisation, diet, work and exercise.
03Is mesh always used?
Not in every case. Mesh use, type and position depend on hernia type, contamination, tissue quality and overall patient benefit.
CLINICAL EVIDENCE
CLINICAL EVIDENCE
The final choice is based on the clinical presentation, individual anatomy and current guidance.
01HerniaSurge · International Groin Hernia Guidelines 2023Updated international guidance for groin hernia managementOFFICIAL SOURCE02European Hernia Society · Midline Incisional HerniaAbdominal-wall guidelineOFFICIAL SOURCE03NIDDK · Inguinal HerniaSymptoms, diagnosis and warning signsOFFICIAL SOURCE
This content is educational and does not replace medical assessment. No technique is appropriate for everyone; benefits, risks and alternatives are discussed individually.
INDIVIDUALISED SURGICAL ASSESSMENT
The right operation starts with the right indication.
Symptoms, investigations and alternatives are reviewed during consultation to create a safe, individualised treatment plan.
REA MED practice & directions