Incisional & ventral hernia repair

A ventral or incisional hernia happens when tissue — usually a little fat or a loop of bowel — pushes through a weak spot in your abdominal wall muscle. This weak spot is often at the site of a previous operation scar, which never quite knitted back together with the same strength. You might notice a bulge, some aching, or a feeling of heaviness — especially when you cough, sneeze, or stand up.

These hernias are repaired using one of three approaches depending on the size of your hernia and your surgical history: a keyhole (laparoscopic) repair called IPOM, a robotic sublay repair where mesh is tucked behind the muscle for extra strength, or an open operation for more complex situations. Which approach suits you best is discussed at consultation.

• A hernia at an old surgery scar that causes you pain or gets in the way of daily life
• A belly button (umbilical) or upper-belly (epigastric) hernia that aches or limits what you can do
• A hernia that could get "stuck" — this is called incarceration or strangulation, and it is a reason to act sooner rather than later
• A hernia that has been growing quickly
• A hernia that has come back after a previous repair
• A bulge that is affecting your confidence, comfort, or ability to do the things you love

• Keyhole or robotic approach means only small cuts — and, in published series, less post-operative pain and faster healing than a large open incision
• A carefully fitted mesh reinforces the weak spot for a long-lasting repair with a low chance of the hernia returning
• Avoids cutting through skin that may already be fragile from previous operations
• Shorter hospital stay — most small-to-medium hernias mean just one night or even a same-day stay
• Depending on the technique used, the mesh is placed either behind the muscle layer (sublay) or against the inner surface of the abdominal wall (IPOM) — both positions protect the repair from the full force of abdominal pressure
• Most patients are mobile and self-caring within a day or two of a keyhole or robotic repair

Every operation carries some risk; here is an honest picture before you decide.

• Seroma (a pocket of fluid under the skin) — this happens in about 20–30 in every 100 cases and can look or feel like the hernia has come back, but it almost always settles on its own within 6–12 weeks. We will keep an eye on it at your follow-up.
• Mesh infection — uncommon, affecting about 1–3 in every 100 patients. If it occurs, it may mean the mesh needs to be removed. Specific precautions are taken to minimise this risk.
• Recurrence (the hernia returning) — about 3–10 in every 100 people over five years, depending on the size of the hernia. This is why we discuss the best repair technique for your situation.
• Bowel injury during keyhole surgery — rare, affecting fewer than 1 in every 100 patients. It can occur when scar tissue from previous operations needs to be carefully separated.
• Ongoing pain near where the mesh is fixed — experienced by about 5–10 in every 100 patients; usually settles over time.
• Wound healing problems — more likely with larger open repairs; your personal risk will be discussed at consultation.

If you take blood thinners, diabetes medication, GLP-1 weight-loss injectables, or iron supplements, please flag this when you book — these need specific adjustments before the procedure. Full details are in the guide above.

• If your weight (BMI) is elevated, the benefits of reducing it before surgery will be discussed with you — even a small loss meaningfully reduces the chance of complications
• A CT scan of your abdomen will be arranged to map out the hernia — its size, shape, and whether any bowel is involved — so there are no surprises in theatre
• If you smoke, stopping before your operation is one of the single most important things you can do to help your healing; the practice team can point you toward support if you need it
• Before the operation, the hernia is marked on your skin and the surgical plan is explained in detail, so you feel prepared on the day

• You will be admitted to Warringal Private Hospital or Epworth Eastern on the morning of your operation and given a general anaesthetic — you will be completely asleep and will not feel anything
• Any scar tissue (called adhesiolysis) that may be holding the bowel against the hernia sac is carefully separated — gently and precisely
• The hernia opening is measured and the right mesh and technique (IPOM, sublay, or TAPP) chosen for your anatomy
• The mesh is placed and secured firmly in position — this is what gives the repair its lasting strength
• Where possible, the muscle layer itself is also sewn closed over the mesh, which reduces the chance of fluid collecting and the hernia coming back
• You will wake up in recovery, then move to the day-stay unit or the surgical ward — most people go home the same day or after one night; larger repairs may need one to two nights

• Day 0–1: You will be encouraged to get up and walk as soon as it is safe — this helps prevent clots and speeds up recovery. You can eat and drink normally.
• Day 1–2: Most people with smaller hernias go home the next day; larger repairs may need 2–3 nights. You will not be sent home until you are comfortable and eating well.
• Week 1–4: Walking and gentle movement are encouraged from the first day. For smaller keyhole repairs, most people feel ready for desk work within 2 weeks; larger or more complex repairs typically need closer to 4 weeks. For the first 1–2 weeks, avoid heavy lifting, pushing, or pulling — a useful guide is nothing heavier than about 5–10 kg (the weight of a small grocery bag). For larger or more complex ventral repairs, heavier lifting and gym-style work should be avoided for around 4 weeks to give the tissues extra time to heal.
• 6–8 weeks: You can gradually return to full activity. Wear your abdominal binder (a supportive wrap around your belly) for the full 6 weeks — it supports the repair while it is settling in.
• Seroma (fluid pocket): If a seroma forms — a soft, fluid-filled lump where the hernia was — do not panic. We will monitor it at your review. It almost always resolves on its own; draining it is rarely needed unless it is painful or not settling.
• You will be guided on when to restart exercise — do not rush this part; the mesh needs time to incorporate properly.
• A post-operative review is routinely arranged 2–6 weeks after your operation, with timing depending on the type of repair — this review is provided at no charge.
• For day-by-day guidance on wound care, binder use, activity progression, and what a seroma feels like, see the Post-hernia-repair aftercare guide on the Resources page.

Post-operative concerns: Please call our rooms on (03) 9816 3951 and leave a message — this will be sent directly as a text to Mr Nguyen. Alternatively, you may text the office mobile on 0499 090 126. We aim to respond promptly during business hours.

Emergencies: For any life-threatening emergency, call 000 immediately or go to your nearest emergency department. Do not wait for a call back from our rooms. For the Austin Hospital Emergency Department: (03) 9496 5000.