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Conditions · Hernia
A hernia is a weakness or defect in the abdominal wall. If the defect is large enough, fat or bowel may protrude as a lump. Professor Tom Hugh assesses and repairs groin and abdominal wall hernias at Royal North Shore Hospital and North Shore Private Hospital.
Open / keyhole
Both approaches used when appropriate
Day stay
Common for many groin and umbilical repairs
St Leonards
Consultations at the Tom Reeve Clinic
RNSH · NSP
Public and private operating hospitals
Hernias are classified as primary or recurrent, and by anatomical site:
| Approach | Typical use | Notes |
|---|---|---|
| Open (small incision) | Many groin and umbilical hernias; complex recurrence | Mesh placed in the anterior abdominal wall layers |
| Laparoscopic (keyhole) | Selected inguinal, femoral, and some abdominal wall hernias | Mesh placed behind the defect; several small incisions |
| Day surgery | Many inguinal, femoral, umbilical repairs | Incisional and complex repairs may need overnight stay |
Source: international HerniaSurge guidelines and 2023 update. Approach and mesh decisions require individual assessment.
Material risks include bleeding, infection, seroma, recurrence, persistent pain or numbness, mesh-related complications, blood clots and anaesthetic complications. Frequency and personal impact vary.
After surgery, written post-operative advice covers wound care, activity, diet and follow-up. Related evidence is on the hernia research hub.
Not always. Small, asymptomatic hernias may be observed. Repair is usually recommended when a hernia causes symptoms, is enlarging, or is cosmetically troubling, provided surgery is safe for that patient. Read when observation is an option.
Many inguinal, femoral and umbilical repairs can be day procedures. Larger incisional or complex hernias more often need an overnight stay. Tom will advise based on the hernia type and your health.
Both open and laparoscopic approaches are used. The choice depends on hernia type, prior surgery, and individual factors. Tom explains the benefits and risks of the preferred technique before you decide.
Seek urgent care for sudden severe pain, a lump that will not reduce, vomiting, or signs of bowel obstruction. These can indicate strangulation, which needs emergency assessment.
In Professor Hugh's study of 540 open mesh repairs, 88% of people having a one-sided repair went home within four hours and 97% had little or no pain at four weeks. Normal activities resumed in a median of 10 to 14 days, depending on the mesh used. Read the 540-repair study.
A groin hernia usually shows as a swelling you can feel, or a bulge when you cough, and is often only mildly uncomfortable. Pain at the inner thigh near the pubic bone that comes on with running or kicking more often comes from the adductor muscles. A careful examination tells the two apart better than a scan. Read the groin pain study.
Often it does not when groin pain is the main problem. In a 2026 study from Professor Hugh's unit, 90% of patients with adductor-related groin pain and a hernia seen only on imaging were satisfied after physiotherapy for the adductor pain, and only one later had a hernia repair. Read the full results.
The American Journal of Surgery 2016
Across 540 repairs, 88% went home within 4 hours and 97% were pain-free or had minimal discomfort at 4 weeks.
ANZ Journal of Surgery 2026
90% of patients with adductor-related groin pain and a scan-only hernia were satisfied after treating the adductor pain alone.
Last updated 25 August 2026