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A hernia is a hole in the abdominal muscle because of which contents like gut and fat come out below the skin. Although many hernias can happen without reason, some are caused by a weak scar from a previous surgery. This particular condition is called incisional hernia and requires more detailed evaluation before treating them. Now, many of these do not cause problems but some may produce pain especially while standing or while performing any activity. Sometimes, the gut may get stuck and their blood supply may get cut off leading to a dangerous condition. This generally needs emergency surgical intervention. Most hernias will need surgery. The general principle is to replace the defect with a mesh - a flat piece of plastic net compatible with human tissue. Meshes can be of many types leading to a wide range of cost. This is important to remember because that is one of the reasons why the cost of hernia repair may vary widely.

There are different techniques of hernia repair. There are open and laparoscopic procedures that generally have the aim to close the defect without tension and then reinforce with an appropriate mesh.

Recent times have seen a rapid proliferation of newer procedures in hernia surgery such as component separation techniques reserved for large complex hernias that were so far thought to be untouchable. Efforts are being made to devise procedures that are less painful. Already, the efforts are showing promise. The recurrence of hernia which is considered the Achilles’s heel is already showing a downward trend and we may consider this as a major achievement and progress in science. A good hernia surgeon would typically be well versed with a wide array of procedures.

— The author is the Director, Digestive Surgery Clinic, Belle Vue and a specialist in bariatrics, hernia and GI surgery