Incisional hernia repair (incisional herniorrhaphy (ventral hernia repair))

What is incisional hernia repair?

An incisional hernia is a bulge that pushes through the weakened scar of a previous operation on the tummy. It is a type of ventral (front-of-tummy) hernia. They can appear months or years after surgery and vary a lot in size.

Incisional hernia repair is an operation to close the gap in the muscle layer and reinforce it, almost always with mesh, because stitches alone come back far more often. Repair can be done as open surgery or by keyhole (laparoscopic) surgery, and larger or complex hernias sometimes need specialist abdominal wall techniques.

Repair is usually advised when the hernia causes symptoms, is enlarging, or there is concern about bowel becoming trapped. Some small or low-risk hernias may be watched, and some people may be advised to lose weight or stop smoking first to improve the chance of a lasting repair.

These hernias can be challenging. Recurrence and wound problems are more common than with simple hernias, and large repairs are bigger operations than people often expect.

Types & techniques

There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.

Stitch-only versus mesh repair

Stitch-only repair of incisional hernias comes back far more often than mesh repair, which is why mesh is the usual choice. The trade-off is small mesh-related risks.

Preparing for your surgery

• See the operating surgeon, who will examine the hernia and may arrange a scan to plan the repair.
• Tell the team about all medicines, especially blood thinners, and any health conditions.
• If advised, work on losing weight, stopping smoking and improving blood sugar control first, as these improve healing and lower recurrence.
• Follow fasting instructions for the day of surgery.
• Arrange a lift home and help at home, especially for larger repairs.
• Plan time off work; larger repairs need a longer recovery.
• Ask whether you may need a hospital stay and how big your operation is likely to be.

What happens

On the day, you will meet the surgeon and anaesthetist to confirm the plan and consent. Most incisional hernia repairs are done under general anaesthetic.

In an open repair, the surgeon opens the old scar, frees and pushes back the contents, closes the muscle layer and places mesh to reinforce it. In a keyhole repair, small cuts are used with a camera to place mesh from inside. Large or recurrent hernias may need more complex surgery to rebuild the tummy wall.

The operation can take from about an hour to several hours depending on size and complexity. Small repairs may be day cases, while larger repairs often need a hospital stay of a few days, sometimes with a drain to remove fluid.

Is this operation right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Anaesthetic choices

The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.

Incisional hernias are more likely to come back and to have wound problems than simple hernias, especially if they are large or recurrent, or if you smoke, have obesity or have diabetes that is not well controlled. Optimising these before surgery can improve the result. Ask your surgeon how big and complex your repair is, your personal chance of recurrence, and whether you should prepare first.

Published figures to discuss

Recurrence and complications vary widely with the size of the hernia, the technique, and your health, and figures rise with longer follow-up. The ranges below come from surgical trials and reviews and are not promises for any individual.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

Recovery — what to expect, and when

Recovery depends a lot on the size of the repair. Small repairs may take a few weeks; large or complex repairs are major operations and can take a couple of months or more to fully recover from.

• Bruising and swelling around the wound
• A firm ridge along the healing wound, and sometimes a soft fluid swelling that settles over weeks
• Pulling or tightness when you cough, sneeze or sit up
• Tiredness for longer after a larger repair

Aftercare

• Take regular pain relief as advised, especially after a larger repair.
• Keep the wound clean and dry, and follow advice on dressings and any drain.
• Support your tummy with a hand when you cough or sneeze in the first days.
• Build up walking gently, but avoid heavy lifting and straining early on.
• Eat well, stay hydrated and avoid constipation.
• Do not drive until you can do an emergency stop comfortably and your team agrees.
• Wear any recommended abdominal support as directed, and keep follow-up appointments.

• Pain relief bought or prescribed
• Loose clothing that does not press on the wound
• Lift home and help at home arranged (more for larger repairs)
• Time off work booked to match the size of repair
• Help with shopping, children or pets
• Clinic and out-of-hours contact numbers saved

Scars and how they heal

Open repair usually reopens and lengthens the old scar; the new scar fades over months but may be longer than before. Keyhole repair leaves several small scars. Scars can be firm or raised at first; sun protection helps them settle. Numbness near the scar is common and usually improves.

⚠ Get urgent help if…

• Sudden severe tummy pain with a hard, very tender bulge that will not push back
• Being sick, a swollen tummy, or not being able to pass wind or open your bowels
• A high temperature, feeling shivery or generally very unwell
• Increasing redness, heat, swelling or discharge from the wound, or the wound opening
• A red, hot, swollen or painful calf, or sudden breathlessness or chest pain
• Bleeding that soaks through dressings and does not stop

Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

A successful repair improves the bulge, eases symptoms and lowers the risk of trapped bowel. Mesh repair lowers, but does not remove, the chance the hernia comes back, and larger hernias have higher recurrence than small ones.

This is often a bigger operation than people expect, and the chance of needing further surgery over time is real. Ask your surgeon for an honest estimate of recurrence and wound problems for a hernia like yours.

Mesh repairs are designed to last, but incisional hernias have a higher chance of coming back than simple hernias, especially when they are large or recurrent, or when wound infection occurs. Keeping a healthy weight, not smoking and controlling diabetes help protect the repair. Recurrence can happen years later, so it is worth knowing the warning signs.

Combining with other procedures

An incisional hernia is sometimes repaired during another planned tummy operation, or alongside removal of excess skin after major weight loss. If extra surgery is suggested, ask what it adds to your risks and recovery so you can decide.

Follow-up & long-term care

After a larger repair you are usually reviewed in clinic to check healing and manage any fluid collection. Smaller repairs may have a single check or clear advice on when to seek help. Report wound problems, swelling or pain promptly, and any return of the bulge.

Revision and secondary surgery reality

• Recurrence is common enough that some people need more than one repair over their lifetime.
• Recurrent and large hernias may need complex abdominal wall reconstruction in a specialist centre.
• A wound seroma usually settles but sometimes needs draining, occasionally more than once.
• Mesh infection, though uncommon, can need the mesh removed and further surgery.

Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.

What good aftercare looks like

• Clear written warning signs for trapped bowel, wound infection, wound breakdown and blood clots, with a named contact route.
• A plan for managing any drain or fluid collection and for wound checks.
• Realistic advice on returning to driving, work and lifting, matched to the size of the repair.
• Honest discussion of recurrence risk and what to do if the bulge returns, including specialist referral where needed.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• The size and complexity of the hernia
• Whether the repair is open, keyhole or a complex abdominal wall reconstruction
• Surgeon and anaesthetist fees
• Theatre and facility costs, and the length of any hospital stay
• The type and amount of mesh used
• Scans before surgery and follow-up appointments

• The surgeon's and anaesthetist's fees
• Theatre, facility and hospital stay costs
• Mesh or other materials used
• Anaesthetic type included
• Follow-up appointments, wound care and any drain management
• The cancellation policy
• What happens, and who pays, if there is a complication or the hernia comes back

On the NHS? Incisional hernia repair is available on the NHS when clinically indicated, with complex repairs often done in specialist centres; private care is used for timing, choice of surgeon or self-pay.

You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a surgeon safely

• Check your surgeon is on the GMC Specialist Register for this area.
• Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
• You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
• Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good surgeon will welcome every one of these.

• How large and complex is my hernia, and what does that mean for my recovery?
• Should I lose weight, stop smoking or improve my diabetes control before surgery?
• What is my personal chance of the hernia coming back?
• Will I need a hospital stay, and might I have a drain?
• What type of mesh will you use, and what are its risks?
• When can I safely return to my type of work and to driving?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the surgeon who carries out my operation, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this operation not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified surgeon for incisional hernia repair

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: British Hernia Society — abdominal wall hernia guidelines Current trends in hernia surgery in NHS England — Ann R Coll Surg Engl Suture versus mesh repair for incisional hernia — NEJM Long-term recurrence and complications after elective incisional hernia repair — JAMA Primary ventral and incisional hernias: comprehensive review — BJS Open European Hernia Society — midline incisional hernia guidelines (PMC) NIHR Evidence — mesh repair reduces recurrence risk in abdominal hernias NHS — hernia (overview and repair)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.