Hernia repair surgery is one of the most common operations performed in the UK, and for most people, it brings lasting relief from discomfort and the risk of complications like strangulation. However, it’s perfectly reasonable to wonder whether the hernia could come back after surgery.
The short answer is yes it can, but recurrence is far less likely with the right surgical approach and a few simple lifestyle changes.
What are the chances of hernia recurrence?
A hernia can return months, or even years, after surgery. Recurrence is more common when the initial repair was performed using open surgery, particularly if it was a repeat operation.
Statistics show that hernias repaired again using open surgery have a recurrence risk of up to 20%. A study looking at long-term recurrence rates of umbilical, epigastric, incisional, parastomal, port-site and other ventral hernia repairs found that the rate of recurrence repair continued to rise over a 15 year period.
With laparoscopic (keyhole) surgery, the recurrence rate drops to around 1%. That’s a dramatic difference, and it’s one reason why many specialists now recommend laparoscopic repair for recurrent hernias whenever appropriate.
Laparoscopic surgery involves placing mesh reinforcement behind the abdominal wall, distributing tension more evenly and promoting a stronger long-term result. Less trauma to the surrounding tissues also means fewer complications and a quicker recovery.
What increases the risk of a hernia coming back?
Several factors can increase the chances of recurrence. Some are out of your control, while others are more manageable. These include:
Smoking: Tobacco use affects tissue healing and weakens collagen structure, which is vital for durable scar tissue. In short, smoking compromises your body’s ability to repair itself after surgery.
Obesity: Carrying excess weight increases pressure on the abdominal wall, which can strain even a well-repaired hernia site. Obesity is also linked to poor wound healing and higher rates of surgical site infection.
Heavy lifting or straining: Intense physical effort too soon after surgery can place pressure on the repair site before it’s fully healed. This includes not only lifting weights but also chronic coughing or straining during bowel movements.
Previous failed repairs: Hernias that have been repaired multiple times, especially using older techniques, are more challenging to fix, and scar tissue can complicate healing.
Chronic conditions: Constipation, chronic cough (such as in asthma or COPD), or urinary difficulties can increase intra-abdominal pressure and strain the repair.
Knowing your personal risk factors means you and your surgical team can take a proactive approach, both before and after surgery.
Practical steps to reduce your risk
A few lifestyle adjustments can go a long way in preventing a hernia from returning. Quitting smoking at least a few weeks before surgery improves circulation, immune function, and wound healing.
Managing your weight can also help. Even a modest reduction in abdominal weight can reduce pressure on your repair. Aim for slow, steady weight loss through a balanced diet and regular movement (within your post-op limits).
Your surgeon will advise on when to return to daily activities and exercise. Gradual reintroduction of movement is key, as rushing recovery increases the chance of complications.
Once you’re cleared to exercise, focus on strengthening your core with low-impact activities like walking or swimming. This supports the abdominal wall and helps prevent future issues.
What to do if you notice symptoms
Even with the best care, it’s possible for a hernia to come back after surgery. Signs include a bulge near your previous repair, aching or pressure in the same area, or discomfort during exertion.
At the Warwick Bowel and Hernia Clinic, we specialise in tailored hernia repair and ongoing care. Whether you’re preparing for your first surgery or dealing with a recurrence, the focus is always on providing long-term relief and helping you feel confident in your recovery.
With the right surgical approach and a few mindful habits, you can significantly reduce the risk of your hernia making an unwelcome return. If you’re concerned that your hernia has returned or about your risk of recurrence, schedule an appointment with Mr Michael Stellakis to discuss the best treatment options.
