Is hernia surgery a major operation? How long it takes, how safe it is, and surgery for an elderly parent

Major or minor: what that means for a hernia

People call an operation major when it needs a long stay, a big cut or a long recovery. A first, one-sided groin hernia repair is at the small end of surgery: one cut of a few centimetres or a few keyhole cuts, about an hour in theatre for most people, and home the same day. The surgeon closes the weak spot, usually with a thin mesh.

It becomes a bigger operation when the hernia is large and has dropped into the scrotum, when it has come back after an earlier repair, when hernias on both sides are fixed together, or when it is done as an emergency. Those can mean a longer operation and a night or more in hospital. The surgeon can tell you which kind yours is after examining you.

How long hernia surgery takes

The NHS gives 30 to 90 minutes for an inguinal (groin) hernia repair. Expect to spend several hours at the hospital on the day: arriving, the anaesthetic check, the operation, then time in recovery until you have eaten, walked and passed urine. Plan for someone to collect you.

Recovery is measured in weeks, not days: most people are comfortable within one to two weeks and avoid heavy lifting for longer. Our guide 'Hernia surgery recovery' goes through work, driving, lifting and sex week by week.

Is hernia surgery dangerous? The honest risks

Complications are uncommon, but you should know them before you agree to the operation:

• Bruising and swelling in the groin, which in men can spread into the scrotum and usually settles over a few weeks
• A wound infection, usually treated with antibiotics
• Difficulty passing urine for a short time after the operation
• A blood clot in the leg, which is why you are asked to get up and walk early
• The hernia coming back, which is less likely when a mesh is used
• Groin pain that lasts beyond three months. International guidelines report this in about 1 in 10 people, usually easing with time, and severe enough to affect work or daily life in roughly 1 to 6 in 100

The dangerous operation is the emergency one

A hernia can trap a loop of bowel and cut off its blood supply. The operation then has to happen that day, often at night, sometimes with part of the bowel removed. The international hernia guidelines found that deaths after emergency repair were roughly 10 to 20 times more common than after a planned repair. Older age and other illnesses add to that risk.

That is the real answer to 'is hernia surgery dangerous'. A planned repair on a day you choose, with your tests done and your medicines reviewed, is far safer than an emergency one. Go to an emergency department straight away if you notice any of these:

• Sudden, severe pain in the lump or the tummy
• The lump becomes hard, tender or changes colour, and you cannot push it back in
• Vomiting, or feeling too sick to keep food down
• You cannot pass wind or open your bowels

Hernia surgery for an elderly parent

Age alone does not rule out a planned repair. A large American study of 2,377 people aged 80 and over found that planned groin hernia repair in people in their eighties had low rates of complications and death. The risk was higher in people over 90 and after emergency operations, and the authors advised repairing hernias in older people early, as a planned operation, rather than waiting for an emergency.

What matters more than the birthday is general health: the heart and lungs, how well diabetes and blood pressure are controlled, any blood-thinning medicines, how well your parent walks, and whether someone can stay with them at home afterwards. The surgeon and anaesthetist review all of this before the date is set. Open repair under a local anaesthetic is an option for some people, and the guidelines recommend it where the surgeon is experienced in that technique.

For an older man with a small hernia that does not hurt, waiting can be reasonable. The guidelines accept watchful waiting for men with no symptoms or very mild ones, because emergencies are rare in that group. But waiting rarely lasts: in the long-term follow-up of a trial the guidelines rely on, an estimated two in three men who chose to wait had gone on to have the operation within about ten years. Our guide 'Can a hernia heal without surgery?' covers waiting, belts and herbs in more detail.

Open or keyhole, and what to ask before you book

Both open and keyhole repair work well, and the choice affects the anaesthetic and the first weeks more than the long-term result. Our guide 'Open vs laparoscopic (keyhole) hernia repair' compares them. Whichever is planned, ask:

• What type of hernia is it, and is it one side or both?
• Open or keyhole, and which anaesthetic do you recommend for me?
• How often do you do this operation?
• Will I go home the same day, and what would make you keep me overnight?
• What does the written quote include: mesh, anaesthetist, theatre, drugs and the review visit?
• Who do I call if I have a problem after I go home?

Common questions