Advanced laparoscopic, retroperitoneal, and open surgical repair for groin and abdominal wall hernias, including complex abdominal wall reconstruction (AWR) for recurrent and large incisional defects.
A hernia occurs when internal tissue or an organ pushes through a structural weakness or tear in the surrounding muscle layers. Because adult hernias do not heal on their own and carry a progressive risk of growing larger, causing pain, or trapping intestines (strangulation), the surgical repair is customized directly to the location and size of the structural defect.
Hernia Surgery Covers More Than One Type of Defect
Groin Hernias (Inguinal & Femoral)
The most common types of abdominal wall defects, occurring primarily in the groin channels. Inguinal hernias form where natural pathways pass through the lower abdominal muscles, while femoral hernias appear just below the groin crease. Femoral hernias carry a particularly high risk of trapping tissue and require prompt surgical repair.
Ventral & Umbilical Hernias
Ventral hernias develop through weaknesses along the vertical midline of the abdominal wall. Umbilical hernias form specifically at the natural weak spot of the navel. In some cases, adults present with an umbilical hernia alongside a separation of the main midline abdominal muscles (diastasis recti), which can be corrected simultaneously.
Incisional & Recurrent Hernias
Incisional hernias form through scar tissue left behind by previous abdominal operations, often driven by poor tissue healing, straining, or metabolic factors. A recurrent hernia is a defect that has returned after a previous repair. Both represent complex structural challenges that require specialized reconstruction rather than simple closure.
Rare Abdominal Hernias (Spigelian & Flank)
Spigelian hernias are uncommon defects that form deeper within the lateral muscle layers of the lower abdomen. Because they sit between the muscle sheets, they are difficult to detect on regular clinical examination alone and carry an elevated risk of bowel obstruction.
Hernia Surgery in Ahmedabad: Procedures We Perform
The selection of the surgical technique balances the standard minimal-access approach against advanced muscle-rearrangement methods for large, complex wall defects.
Laparoscopic Groin Hernia Repair
(TEP / TAPP)
The standard approach for groin hernias, performed entirely through small abdominal ports using a camera.
Totally Extraperitoneal (TEP): Dissection and permanent mesh placement are performed outside the abdominal cavity within the pre-peritoneal space, ensuring the mesh never comes into contact with the bowel or internal organs.
Transabdominal Preperitoneal (TAPP): Access is gained through the abdomen to slide a protective mesh behind the groin floor, highly useful for complex or bilateral (both sides) groin defects.
Advanced Retroperitoneal Repairs
(eTEP Rives-Stoppa)
An extended-view extraperitoneal technique used for larger ventral and incisional hernias. The surgeon accesses the retro-rectus space behind the abdominal muscles without entering the main peritoneal cavity. An uncoated mesh is placed safely behind the muscle layers and away from the internal organs, restoring the natural anatomy of the abdominal midline.
Abdominal Wall Reconstruction
with Transversus Abdominis Release
(eTEP TAR)
Reserved for complex, large incisional defects where the edges of the abdominal wall cannot be pulled back together normally. The surgeon carefully releases the deepest flat muscle layer (transversus abdominis) to slide the abdominal walls back into alignment. This creates a massive space to secure a permanent reinforcing mesh, restoring full mechanical function to the core.
Intra-Abdominal Only Mesh (IPOM Plus)
A procedure where a specialized, dual-layered coated mesh is placed directly inside the abdominal cavity over the closed hernia defect. The inner coat prevents the mesh from sticking to the intestines. This is an efficient option utilized primarily for specific ventral hernias or for patients who cannot tolerate prolonged anesthesia times.
Before Hernia Surgery: What to Expect
A detailed clinical boundary assessment and optimization protocol ensure low recurrence rates and steady post-operative healing.
1. Clinical Assessment & Risk Mapping
An analysis of the hernia's stability (whether it can be pushed back in easily or stays fixed) alongside managing chronic risk factors like chronic coughing, smoking, or uncontrolled blood sugars.
2. High-Resolution CT Imaging
For large incisional, recurrent, or suspected Spigelian hernias, a dedicated abdominal CT scan is scheduled to measure the exact size of the muscle defect, check the volume of the contents outside, and evaluate the muscle architecture.
3. Review of Prior Operative Records
For recurrent cases, previous surgical summaries are thoroughly reviewed to identify the type of technique, closure, and mesh used previously, which aids in planning the new anatomical approach.
4. Customized Structural Planning
The diagnostic findings dictate whether a standard laparoscopic repair, an extraperitoneal mesh placement, or a formal component-separation reconstruction is needed.
Recovery After Hernia Surgery
Post-operative protocols focus on early mobility while protecting the healing muscle layers and the reinforcing mesh.
Days 1–3
Most standard laparoscopic patients return home on the day of surgery or the following morning. Normal walking is encouraged immediately to boost circulation and prevent constipation. Mild local swelling or temporary shoulder discomfort from the surgical gas is common.
Week 1
Patients consume a regular diet and take prescribed oral pain relievers. Waterproof dressings remain in place, and a follow-up review is scheduled at the end of the week. Driving is avoided during these initial 7 days.
Weeks 2–3
Light daily routines and desk work are safely resumed. If a support binder was prescribed for a large ventral or incisional repair, it should be worn as directed. A strict lifting restriction is enforced, keeping all lifted weights under 5 kg to protect the muscle lines.
Weeks 6+
Strenuous core activities, heavy lifting, or intense athletic training are reintroduced gradually based on structural tolerance and direct guidance from the surgical team.
About Dr Sourabh Damani
Practicing as a Gastrointestinal and Laparoscopic Surgeon in Ahmedabad, Dr. Sourabh Damani possesses a specialized interest in complex hernia management, advanced retroperitoneal anatomy, and abdominal wall reconstruction (AWR).
Performs laparoscopic TEP and TAPP repairs for groin hernias, and advanced eTEP, Rives-Stoppa, and TAR techniques for incisional defects.
Manages complex recurrent hernia repairs, utilizing detailed pre-operative CT tracking and tailored component-separation strategies.
Corrects umbilical hernias simultaneously alongside diastasis recti repairs to restore uniform abdominal line aesthetics and strength.
Prioritizes minimally invasive retroperitoneal approaches to lower post-operative chronic pain, limit mesh exposure to organs, and minimize wound complications.
Hernia Surgery in Ahmedabad: Frequently Asked Questions
Why is a mesh required for adult hernia repairs, and is it permanent?
Adult hernia defects in the muscle wall are mechanical failures that do not knit back together on their own. Closing the hole with simple sutures puts significant tension on the surrounding tissues, leading to high recurrence rates. A surgical mesh acts as a permanent, flexible scaffold that allows your body’s natural collagen tissue to grow into it, reinforcing the repair and reducing the risk of the hernia returning.
What is the difference between a reducible, incarcerated, and strangulated hernia?
A reducible hernia is a soft bulge that can be gently pushed back inside the abdomen or disappears when you lie down. An incarcerated hernia is trapped outside the muscle wall and cannot be pushed back in, causing persistent discomfort. A strangulated hernia occurs when the blood supply to the trapped tissue or intestine is completely cut off; this is a medical emergency that causes severe pain and requires an immediate operation.
Can a hernia return even after an advanced mesh repair?
While advanced minimally invasive techniques and proper mesh placement lower recurrence rates significantly, hernias can still recur. Recurrences are usually driven by systemic strain factors that weaken tissue healing over time, such as persistent smoking, chronic coughing, heavy manual lifting before the wall is fully healed, obesity, or uncontrolled diabetes.
How do I know if my incisional hernia requires a complex abdominal wall reconstruction (AWR)?
Small incisional hernias can often be managed with straightforward laparoscopic mesh repairs. However, if the hernia is large, if the abdominal muscles have pulled far apart, or if multiple past attempts at repair have failed, a formal abdominal wall reconstruction is necessary. This allows the surgeon to safely separate and slide the natural muscle sheets back into the center to rebuild a strong, functional abdominal wall.
Book Hernia Surgery in Ahmedabad
Please bring all previous operating summaries, details of mesh brands used in prior operations if available, and any recent abdominal ultrasound or CT scan films. The first visit centers on an accurate physical evaluation and imaging review to design a permanent, stable repair path.