Groin and Abdominal Wall Hernia Care

Individualised care for groin and abdominal hernias. Dr Prasad Bhukebag uses open, laparoscopic and robotic techniques. The approach depends on the hernia, your health and your goals.

Dr Prasad Bhukebag delivering FALS Hernia Faculty Masterclass at Breach Candy Hospital
Faculty oration on Advanced Abdominal Wall Reconstruction and Hernia Surgery

Understanding Hernias and Repair Options

A hernia occurs when tissue pushes through a weakness in the abdominal wall. You may notice a bulge or discomfort when lifting, bending or standing. Hernias do not usually heal by themselves. A small symptom-free hernia may not need immediate repair, but pain, enlargement, activity limitation or higher-risk anatomy commonly leads to surgery.

Author on Giant Groin Hernias

Dr Bhukebag contributed the chapter "Management of Giant Groin Hernias" to the Textbook of Laparoscopic, Endoscopic and Robotic Surgery (Jaypee Brothers, 2024).

Conditions Commonly Treated

Groin Hernias: Inguinal and Femoral

Inguinal hernias occur in the groin; femoral hernias occur lower down, near the top of the inner thigh. Both may cause a lump or discomfort. Femoral hernias need prompt surgical assessment because complications are more likely. The repair approach depends on the hernia and your health.

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Umbilical hernias cause a bulge at or near the navel. Epigastric hernias occur above the navel, between the navel and breastbone. Painful or enlarging hernias are commonly repaired. Defect size, abdominal-wall strength and individual risk factors guide whether sutures or mesh are used.

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Incisional Hernia

An incisional hernia develops through or near an old surgical scar. Surgical repair uses an individual reconstruction plan to close the defect and reinforce the abdominal wall.

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Assessment also covers recurrent and complex hernias and less common abdominal wall hernias, such as Spigelian hernias. The type, location and any previous repair help guide an individual treatment plan.

Procedures Offered

Dr Bhukebag considers the hernia anatomy, symptoms, previous surgery and your overall health when planning repair:

Groin Hernia: Keyhole Repair (TEP or TAPP)

This keyhole approach places mesh behind the abdominal wall when the diagnosis and anatomy support it.

  • Several small laparoscopic incisions
  • Both sides can sometimes be addressed in one operation
  • Early walking encouraged when safe

Navel or Incisional Hernia: Mesh Behind the Muscles

For selected abdominal-wall repairs, mesh can be placed behind the abdominal muscles and away from the bowel. This is called a retrorectus repair.

  • Mesh placement planned to protect surrounding structures
  • Supports abdominal wall function
  • Considered for navel and scar hernias after assessment

Large or Recurrent Hernia: Abdominal-Wall Reconstruction

Selected complex hernias need release of deeper muscle layers, sometimes called TAR, so the midline can close with less tension and broad mesh reinforcement.

  • Considered for complex repairs where indicated
  • Can reduce closure tension in some repairs
  • Aims to restore abdominal-wall continuity

Comparing Hernia Surgical Approaches

Swipe sideways to compare the approaches.

Feature / Approach Laparoscopic (TEP / TAPP) Robotic-Assisted (TAPP / Selected Abdominal-Wall Reconstruction) Open Anatomical Repair
Incision Size Several small ports; number and size depend on the repair Several robotic ports; number and size depend on the system and repair One or more incisions; size depends on the hernia and reconstruction
Common considerations Many groin hernias and selected ventral hernias Selected groin, ventral or complex repairs where practical benefit justifies availability and cost Primary or large groin hernias, local-anaesthetic repair, emergencies and complex reconstruction
Admission planning Day-care or inpatient care depends on the repair and recovery Day-care or inpatient care depends on the repair and recovery Day-care or inpatient care depends on the repair and recovery
Return to usual activity Individualised by pain, occupation and recovery Individualised by the repair and recovery Individualised by the repair and recovery

Discuss the Right Next Step for Your Hernia

Book a consultation to review your symptoms, examination findings and imaging. If repair has already been advised, bring the reports for a second opinion; the approach depends on the hernia and your overall health.

Book an Appointment Second-opinion enquiries welcome · Bring recent imaging reports