16th January 2025 by Cherry Lai 3 Min Read
What is a hernia and how do you know if you have one? From a small hernia at the groin to ones that require surgery, recognising the symptoms early is key. Here, Dr Sujit Singh Gill, Consultant Vascular and General Surgeon at The Vascular & General Surgery Centre, answers three of our most pressing questions about these lumps, including when hernia surgery might be necessary.
What is a hernia and how serious is it?
A hernia occurs when an organ or tissue pushes through a defect or weak spot in the wall surrounding it. This most commonly happens in the abdomen or groin. Our abdominal cavity, which holds our internal organs such as the liver, kidneys, stomach and small and large intestines, is surrounded by muscle and a strong fibrous sheet of tissue known as fascia. A hernia occurs when there is a weak spot in the fascia. With repeated pressure – such as from straining, core muscle activation or a chronic cough – this defect eventually gives way. This leaves a channel through which internal organs (usually the intestine) can move into the subcutaneous space.
In addition to the most common hernia, which is an inguinal hernia (at the groin), other hernia types include umbilical (or belly button) and incisional hernia (caused by an incompletely healed surgical wound).
A hernia can be a serious problem if the intestine passes through it. This is because there is a risk that the intestine may get trapped in the tunnel. This may result in swelling and gangrene, a process known as strangulation. Because we cannot tell which hernias are at risk, we usually recommend prophylactic (or preventative) repair of inguinal and incisional hernias.
What hernia symptoms should I watch out for?
We have three relatively weak spots in the fascia surrounding our internal organs: one in each groin (known as the inguinal canals) and one at the belly button, where the umbilical cord used to be attached. Other weak spots can develop after a surgery if the fascial wound doesn’t heal properly. This is known as an incisional hernia.
In terms of symptoms, a hernia is identified when a reducible lump appears, especially during straining or coughing. This lump typically disappears when lying down. Usually, the lump isn’t painful, though those with a hernia at the groin may experience a sense of discomfort or a draggy sensation in the groin area. Some patients do feel pain, which improves when the lump is reduced. However, if there is continuous, progressively worsening pain together with a previously reducible lump that is now not reducible, strangulation may have occurred. This is an urgent situation.
What are the treatment options and do I need surgery?
Inguinal hernia repair has come a long way. The standard-of-care treatment is laparoscopic (keyhole) repair. The benefits of this technique over traditional open surgery include shorter recovery (patients can return to full exercise in two to three weeks, compared to six weeks for open repair) and less post-operative pain. The procedure is typically performed as day surgery.
Umbilical hernias can also be repaired laparoscopically, though many are small enough that there is no significant benefit of keyhole surgery over open surgery. These, too, are repaired as a day procedure.
I usually recommend hernia surgery for inguinal and incisional hernias when the diagnosis is made and not when they are symptomatic. This is because, once strangulation has occurred, the patient is at risk of significant, even life-threatening, complications. For this reason, we prefer to repair them prophylactically. As for umbilical hernias, many individuals have had one that has been present for years without any changes in size. Some of these can be safely left alone.
More about the doctor
Dr Sujit Singh Gill is the director and consultant surgeon at The Vascular and General Surgery Centre. He specialises in peripheral arterial disease management, hernia repair, varicose vein disease and more.

Cherry Lai
Newly calling Singapore home, Cherry is a lifestyle editor from Hong Kong with a decade of experience writing about beauty, design, wellness and food. Off duty, she loves curling up with a good podcast and hunting down the city’s best food spots with her husband.
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