Incisional & Ventral Hernia Repair

Overview

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.

Mr Nguyen fixes these using one of three approaches depending on your hernia's size and your 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. He will talk you through which approach suits you best at your consultation.

Who needs this procedure?

• 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

Benefits

• Keyhole or robotic approach means only small cuts — less pain and faster healing than a big 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
• You can expect to get back on your feet relatively quickly

Risks & considerations

Every operation carries some risk, and it is important to us that you understand yours before you decide. Here is an honest picture:

• 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. Mr Nguyen takes specific precautions 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 — very 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; Mr Nguyen will explain your personal risk at consultation.

Before the procedure

• If your weight (BMI) is elevated, Mr Nguyen will talk with you about the benefits of reducing it before surgery — even a small loss significantly 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; Mr Nguyen's team can point you toward support if you need it
• Mr Nguyen will mark the hernia on your skin and talk through exactly what he plans to do, so you feel prepared on the day

On the day

• You will have a general anaesthetic — you will be completely asleep and will not feel anything
• Mr Nguyen carefully separates any scar tissue (called adhesiolysis) that may be holding the bowel against the hernia sac — this is done gently and precisely
• He measures the hernia opening and chooses the right mesh and technique (IPOM, sublay, or TAPP) 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

Recovery & aftercare

• 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: Take it easy. For smaller keyhole repairs, most people feel ready for desk work within 2 weeks; larger repairs typically need closer to 4 weeks. Do not lift anything heavier than about 5 kg during this time.
• 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.
• Mr Nguyen will guide you on when to restart exercise — do not rush this part; the mesh needs time to incorporate properly.
• A follow-up appointment with Mr Nguyen is arranged within 2–6 weeks of your operation (timing depends on the type of repair). This visit is provided at no charge.

Related patient guides

We have put together a collection of plain-language articles to help you and your family understand what is happening and what to expect — before, during, and after your surgery.