Hernias are a common condition in Singapore, affecting thousands annually. Unfortunately, they do not heal on their own. Hernia surgery remains the definitive treatment, especially when symptoms like pain, bulging, or digestive issues appear or worsen.
Whether you are going for a scheduled procedure at a private clinic or through a public hospital system, understanding what to expect can reduce anxiety and improve outcomes.
What You Need to Know Before Undergoing Surgery
While some hernias may not require immediate surgical intervention, most will eventually need repair to prevent complications. Over time, even a small hernia can grow larger, become painful, or lead to dangerous conditions.
Types of Hernias That May Require Surgery
Umbilical Hernia
An umbilical hernia presents as a bulge around the navel area, where the abdominal wall is naturally thinner. It is common in newborns but can also occur in adults, especially women who have had multiple pregnancies or individuals with obesity.
Inguinal Hernia
This is the most frequently diagnosed type of hernia, particularly in men. It occurs in the groin region when abdominal tissue or part of the intestine pushes through the inguinal canal. Inguinal hernias rarely improve on their own and can result in serious complications if left untreated.
Incisional Hernia
Incisional hernias develop through a weakened area in the abdominal wall following prior surgery. Repair often requires a mesh-based reinforcement to restore abdominal wall integrity and reduce the chance of recurrence.
Femoral Hernia
They emerge near the upper thigh, just below the groin, and are typically harder to detect than other types. While some cases are asymptomatic, femoral hernias carry a higher risk of strangulation due to the narrowness of the femoral canal.
Types of Surgery
Open Hernia Repair
This conventional approach involves making a single larger incision directly over the hernia site. The hernia surgeon manually pushes the protruding tissue back into place and reinforces the weakened abdominal wall.
The procedure is commonly used for:
- Large or complex hernias
- Strangulated hernias that require urgent intervention
- Patients unsuitable for general anaesthesia
Laparoscopic Hernia Repair
The procedure is performed through 3 to 4 small incisions in the abdomen. A slender instrument equipped with a camera gives the surgeon a magnified view of the internal area on a screen. Surgical instruments are inserted through other small openings to reposition the herniated tissue and place a mesh over the defect.
This technique is ideal for:
- Smaller hernias
- Hernias that have recurred after a previous repair
- Bilateral inguinal hernias (on both sides)
Robotic Hernia Repair
This approach uses robotic arms controlled by the surgeon, allowing greater precision and flexibility than traditional laparoscopy. It can be particularly beneficial for large or complex hernias, including ventral and incisional types.
Mesh Used in the Repair
Not every hernia repair demands the use of mesh, but it has become a mainstay in modern hernia surgery for good reason. Surgeons often opt for mesh when they aim to reduce the risk of recurrence, especially in larger or more complex hernias. The mesh acts as a support layer over the weakened muscle, helping to reinforce the area where the tissue protrudes.
Common types of surgical mesh include:
- Synthetic Mesh: Made from plastic (e.g., polypropylene or polyester), this is the most commonly used type due to its strength and long-lasting support.
- Biologic Mesh: Derived from animal or human tissue, this mesh is designed to be gradually absorbed by the body while encouraging new tissue growth. It is often used in complex hernia repairs, intended to dissolve over time as the body heals and reinforces the repair.
- Hybrid Mesh: Combining elements of both synthetic and biologic materials, hybrid mesh aims to offer the benefits of both types, providing strong reinforcement while promoting tissue integration.
Risks and Potential Complications
Hernia repair is widely regarded as a safe and effective procedure, but like all operations, it carries a degree of risk. Understanding these potential complications helps patients prepare adequately for their recovery. Though uncommon, potential complications include:
- Infection at the surgical site
- Hernia recurrence even after successful repair
- Bleeding or accumulation of blood near the surgical site (hematoma)
- Adverse reactions to anaesthesia
- Nerve damage, persistent pain, or numbness in the surgical area
- Injury to nearby organs or tissues during the procedure
Preparation for Hernia Surgery
Preparing for hernia surgery helps avoid complications and sets the foundation for a smoother, faster recovery.
- Make sure your surgeon knows about any long-term health conditions, such as heart disease, diabetes, respiratory illnesses, or if you are pregnant.
- Some medicines, especially blood thinners, anti-inflammatories, or supplements, may need to be paused in the days leading up to surgery to reduce the risk of bleeding or complications.
- You will likely be asked to stop eating or drinking after midnight before the day of surgery. This is important if you will be under general anaesthesia.
- While many hernia surgeries are done as day procedures, some patients may stay overnight for observation. Bring necessary items, including identification, insurance documents, and a comfortable change of clothes.
What to Expect on the Day of Surgery
Expect to arrive at the hospital several hours before your hernia surgery. A nurse or anaesthetist will confirm your medical history, discuss the type of anaesthesia being used, and answer any last-minute questions.
If you are under general anaesthesia, you will be asleep and unaware of the procedure. For local or regional anaesthesia, you may be awake but sedated. Any discomfort should be reported so adjustments can be made immediately.
Pain is usually well-controlled during the operation, and your team will continue to monitor you closely after the procedure.
The length of the surgery can vary based on the complexity of the hernia:
- Simple hernias may be repaired in as little as 30 to 45 minutes.
- Moderate cases may take one to two hours.
- Complex or recurrent hernias can extend up to four or five hours, particularly if robotic tools are used.
What Is the Post-Surgery Recovery Process?
In most straightforward cases, you will likely be discharged the day after your operation. Some laparoscopic procedures even allow for same-day discharge. During this time, your body is still flushing out anaesthetic medication, so rest and only do minimal movement.
Pain is typically most noticeable in the first 2 or 3 days, then reduces considerably. Over-the-counter medications or prescribed analgesics usually manage it well.
As for the daily activities, many people resume light office duties within 3 to 5 days. Walking is encouraged from day one post-surgery. This boosts circulation, reduces the risk of blood clots, and aids digestion. However, heavy lifting and vigorous workouts should be avoided for at least 4 to 6 weeks unless your surgeon gives clearance.
Treatment Cost
The base fee for hernia surgery usually starts from a few thousand dollars and can rise significantly depending on the type and complexity of the procedure. Simple, single-site hernia repairs often cost less than complicated or recurrent cases. As a general guide:
- Public hospitals offer subsidised rates for eligible Singaporeans and permanent residents, particularly for B2 and C class wards.
- Private hospitals and specialist clinics charge higher fees due to personal surgeon selection, shorter waiting times, and private room options.
Many patients rely on MediSave, Integrated Shield Plans, or employer-provided health insurance to offset surgical fees. However, coverage depends heavily on your specific policy terms. It is advisable to check with both your insurer and the clinic administrator before confirming surgery.
Conclusion
Following your pre-surgery instructions plays a crucial role in ensuring your hernia repair goes as smoothly and safely as possible. If you have questions about your medication, your recovery timeline, or any unusual symptoms in the lead-up to your surgery, do not hesitate to reach out to your health provider.
Whether you are unsure about what to expect or just want clarity before your procedure, we encourage you to discuss with our dedicated hernia specialist. For enquiries, you may email enquiry@liverpancreassurgery.sg