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Hernia Surgery In Singapore

Dr Thng Yongxian

Hernia & General Surgeon
MBBS • MMed • MRCS (IRE) • FRCSED • FAMS

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What Is a Hernia

A hernia occurs when an internal part of the body protrudes through a weakness or defect in the surrounding muscle or connective tissue. The most common sites are the abdomen and groin, though hernias can develop wherever the abdominal wall is structurally compromised.

 

Most hernias result from a weakened abdominal wall, allowing internal structures such as the intestine, omental fat, or bladder to push through. A visible bulge at the affected site is often the first noticeable sign.

 

Hernias do not resolve on their own. While some remain asymptomatic for extended periods, all carry a risk of progression. In severe cases, a hernia can become incarcerated (trapped) or strangulated (blood supply cut off), both of which require immediate hernia surgery. 

 

Consulting a hernia specialist in Singapore early allows for an accurate diagnosis and a hernia treatment plan before complications develop.

Symptoms of a Hernia

You may experience the following if you have a hernia. If your symptoms are persistent or worsen, consult a qualified doctor or hernia specialist for an accurate diagnosis and to discuss potential treatment or repair.

  • A noticeable bulge or lump in the abdomen or groin.

  • Discomfort, aching, or a feeling of pressure at the bulge site.

  • Pain that worsens when coughing, bending over, or lifting heavy objects.

  • A heavy or dragging sensation in the groin.

If you experience the following, it may indicate a strangulated hernia, which requires immediate medical attention:

  • Sudden, severe pain that quickly intensifies.

  • Redness, warmth, or discolouration over the hernia bulge.

  • Nausea and vomiting.

  • The hernia becomes firm or tender and cannot be pushed back in.

Causes and Risk Factors

A hernia develops due to a combination of muscle weakness and strain on the abdominal wall. Various conditions and activities can increase this pressure, making it more likely for a hernia to occur and eventually require treatment or repair.

  • Weak abdominal wall (congenital or acquired)


    Some individuals are born with weaker abdominal walls. For others, this weakness may develop over time due to ageing, injury, or strain, creating a susceptible spot for a hernia to push through.

  • Heavy lifting or straining


    Repeatedly lifting heavy objects, especially with improper form, can increase intra-abdominal pressure, forcing tissue through a weak point in the muscle, forming a hernia.

  • Chronic coughing or constipation


    Chronic cough from smoking or ongoing constipation can raise abdominal pressure and contribute to the development or worsening of a hernia.

  • Obesity or pregnancy


    Both obesity and pregnancy place sustained pressure on the abdominal muscles, weakening the abdominal wall over time.

  • Prior abdominal surgery


    The site of an incision from a previous surgery can be a structurally weak point. An incisional hernia may develop at this scar, sometimes even years after the initial operation.

  • Family history of hernias


    A family history may suggest a genetic predisposition to weaker connective tissues, potentially making you more susceptible to developing a hernia. It's always useful to mention this to your doctor.

Indications for Hernia Surgery

Hernia surgery is recommended based on several factors that assess the severity, symptoms, and potential risks associated with the hernia. Here are the primary indications for opting for surgical repair:

  • Symptomatic Hernias: Hernias that cause pain and discomfort, or interfere with daily activities often require surgical intervention to relieve symptoms and prevent further health complications.

  • Increasing Size: Hernias that continue to grow or change shape are typically recommended for surgery to prevent the risk of incarceration or strangulation, which can lead to more serious conditions.

  • Incarcerated Hernia: When a hernia becomes stuck in the groin or abdominal wall, it can cause severe pain and require urgent surgical repair to avoid further complications.

  • Strangulated Hernia: A critical and life-threatening condition where the blood supply to the herniated tissue is cut off. Surgery is required immediately to prevent tissue death and potentially fatal complications.

  • Cosmetic or Functional Reasons: Some patients may opt for surgery due to cosmetic concerns or functional impairment caused by the hernia, especially if it impacts their quality of life.

Enquire About Hernia Treatment

Consult our fellowship-trained hernia surgeon for an accurate diagnosis and to discuss a suitable hernia repair and treatment plan in Singapore today.

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Non-Surgery Treatment Options for Hernia

Surgery is the only definitive way to repair a hernia. That said, not every hernia requires immediate surgical intervention. For patients whose hernia is asymptomatic, and where other possible causes of raised intra-abdominal pressure (such as chronic cough, constipation, or an enlarged prostate) have been excluded, a period of observation may be appropriate. A hernia doctor in Singapore will assess your individual condition to determine whether a conservative approach is suitable for you.

 

Conservative management focuses on reducing discomfort and preventing the hernia from worsening, rather than correcting the underlying defect. Options may include:

  • Hernia truss or binder: A supportive undergarment worn over the affected area to keep the protruding tissue in place and relieve discomfort.

  • Weight management: Reducing excess body weight can lower intra-abdominal pressure and ease strain on the weakened area.

  • Dietary adjustments: For hiatal hernias in particular, avoiding foods that trigger acid reflux, eating smaller meals throughout the day, and staying adequately hydrated can help manage symptoms.

  • Activity modification: Avoiding heavy lifting and exercises that place excessive strain on the abdomen can prevent the hernia from enlarging.

These measures do not repair the underlying defect and are not a substitute for hernia treatment. A hernia managed conservatively should be monitored.

Hernia Surgery

Hernia surgery, or herniorrhaphy, is a common surgical procedure used to repair hernias, which occur when an organ or fatty tissue squeezes through a weak spot in a surrounding muscle or connective tissue. Hernias most commonly occur in the abdomen, but can also appear in the groin, upper thigh, and belly button areas.

 

Dr Thng Yongxian is an expert in minimally invasive hernia surgery and well-versed in advanced ventral hernia repair techniques to support faster recovery and reduced discomfort after the operation. He has a proven track record in successful hernia surgeries and provides consultations for personalised hernia treatment plans built around your specific diagnosis and lifestyle needs.

Types of Hernias Treated with Surgery

Hernias come in various forms, and understanding the different types commonly treated with surgery can help identify and diagnose these conditions. Here are the main types of hernias Singaporeans often face that often require surgical intervention:

Inguinal Hernia

The most common type occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles, often in the inguinal canal in the groin area. This type is more common in men than women.

Femoral Hernia

Less common and more likely to occur in women; this hernia appears in the upper thigh, just below the groin. It happens when tissue pushes through the wall of the femoral canal.

Umbilical Hernia

Occurs near the belly button when part of the small intestine passes through the abdominal wall. This type is most commonly seen in infants but can also affect adults.

Incisional Hernia

Develops through a scar left from a previous abdominal surgery, where the intestine pushes through the weakened abdominal tissue.

Hiatal Hernia

Involves the stomach protruding into the chest through the hiatus, an opening in the diaphragm. Unlike abdominal wall hernias, hiatal hernias require a different surgical approach, often involving techniques that address the unique anatomical location.

Preparing for Hernia Surgery

Proper preparation for hernia surgery ensures a successful outcome and minimises the risk of complications. Here are the key steps involved:

Medical Evaluation

  • Before surgery, a thorough medical evaluation is conducted to assess your overall health and any risks associated with anaesthesia. This may include blood tests, imaging studies, and discussions about any existing medical conditions.

Medication Review

  • Before undergoing surgery, patients need to disclose all medications, including over-the-counter drugs and supplements, especially those that might affect blood clotting. It may need to be adjusted or stopped temporarily.

Fasting

  • You will likely be instructed to fast for several hours before the surgery, usually starting at midnight before the day of the procedure. This is to reduce the risk of aspiration during anaesthesia.

Surgical Options for Hernia

Your choice of hernia surgery in Singapore depends on factors like the type and size of the hernia, your overall health, and the recommendation of your specialist surgeon. A consultation with a doctor will determine the best approach for your treatment.

1. Open Hernia Repair (Herniorrhaphy)

This traditional hernia repair involves a surgeon making an incision directly over the hernia. The weakened muscle wall is then repaired, often with surgical mesh for added strength.

 

The following steps outline what a typical open hernia repair procedure in Singapore involves:

 

  1. Anaesthesia and preparation: General anaesthesia is administered. The skin over the hernia site is cleaned and sterilised before the procedure begins.
  2. Incision and exposure: A single incision (typically 6–8 cm) is made directly over the hernia. The hernia sac is exposed and isolated from the surrounding tissue.
  3. Reduction and repair: The herniated tissue is gently returned to its correct position within the abdomen. The weakened abdominal wall is repaired by suturing the muscle edges together. A surgical mesh is typically placed over the repair site to reinforce the area.
  4. Verification and closure: The surgeon confirms the repair is secure and the mesh correctly positioned before closing the incision with sutures or staples.
  5. Postoperative care: The patient receives guidance on wound care, activity restrictions, and signs of infection to monitor during recovery. Follow-up visits are scheduled to assess healing.

2. Laparoscopic Hernia Repair

This minimally invasive hernia repair uses several small incisions and a tiny camera (laparoscope) to guide the surgery. This approach often reports a quicker recovery and less postoperative discomfort.

 

The following steps outline what a typical laparoscopic (minimally invasive) hernia repair procedure in Singapore involves:

 

  1. Anaesthesia and preparation: General anaesthesia is administered. The abdomen is gently inflated with carbon dioxide gas to create working space for the surgical instruments.
  2. Port placement: Several small incisions (typically around 1 cm each) are made in the abdomen. A laparoscope with a camera is inserted through one port, and surgical instruments through the others.
  3. Visualisation and reduction: The laparoscope transmits real-time images to a monitor, allowing the surgeon to locate and assess the hernia precisely. The herniated tissue is carefully pushed back into the abdominal cavity.
  4. Mesh reinforcement: A surgical mesh is placed over the abdominal wall defect to strengthen the repair and reduce the likelihood of recurrence.
  5. Closure and recovery: The small incisions are closed with sutures, staples, or surgical glue. Patients typically experience less postoperative discomfort compared to open hernia repair, with a shorter return to normal activities.

3. Robotic Hernia Repair

An advanced laparoscopic surgery where a surgeon controls robotic arms for enhanced precision. It is often considered for complex or recurrent hernia repair cases that require intricate work.

 

The following steps outline what a typical robotic hernia repair procedure in Singapore involves:

 

  1. Anaesthesia and preparation: General anaesthesia is administered. The patient is positioned, and the abdominal area is sterilised before the robotic system is set up at the surgeon’s console.
  2. Port placement: Small incisions (usually 3–4) are made in the abdomen for the robotic instruments and camera. The surgeon operates from a console with a magnified, three-dimensional view of the surgical field.
  3. Hernia identification and reduction: The robotic arms, guided by the surgeon, locate and isolate the hernia. The herniated tissue is gently returned to its correct anatomical position.
  4. Repair and mesh placement: The abdominal wall defect is repaired with sutures, and a surgical mesh is placed to provide durable reinforcement. The enhanced precision of robotic guidance is particularly relevant for complex or recurrent cases.
  5. Closure and recovery: The incisions are closed, and a sterile dressing is applied. Recovery is generally comparable to laparoscopic hernia repair, with less postoperative discomfort than open surgery.

4. Emergency Hernia Surgery
(Strangulated or Incarcerated Hernias)

Urgent hernia treatment is required for strangulated or incarcerated hernias, where tissue is trapped. Immediate surgery is performed to prevent serious complications and restore blood flow.

 

The following steps outline what an emergency hernia surgery procedure in Singapore typically involves:

 

  1. Urgent assessment: The patient is evaluated for signs of incarceration or strangulation, which may include sudden severe pain, a firm or tender hernia bulge, nausea, and vomiting. General anaesthesia is administered promptly once the decision to operate is confirmed.
  2. Incision and access. A larger incision is made to allow rapid access to the affected area and surrounding tissue.
  3. Assessment of herniated tissue: The surgeon examines the trapped tissue to determine its viability. In strangulation cases, blood supply to the herniated tissue may have been partially or fully compromised.
  4. Tissue repair or resection: If the herniated tissue remains viable, it is returned to the abdominal cavity. Tissue that cannot be preserved is removed, and the remaining structures are rejoined.
  5. Abdominal wall repair and closure: The abdominal wall defect is repaired, typically with mesh reinforcement where appropriate. The incision is closed, and the patient is monitored closely during recovery for complications such as infection or disrupted bowel function.

For patients with cirrhosis or specific tumour characteristics, a liver transplant may be recommended. This procedure involves replacing the diseased liver with a healthy liver from a donor.

Comparing Surgical Approaches: Keyhole vs. Open vs. Laparoscopic Incisional Hernia Repair

When deciding on the most suitable surgical approach, it’s important to understand how the techniques differ. Keyhole (laparoscopic) surgery is commonly recommended for its smaller incisions, reduced discomfort, and quicker recovery time. Open hernia repair may be preferred in cases where the hernia is particularly large or complex. Meanwhile, laparoscopic incisional hernia repair is often used for hernias that develop at previous surgical sites, allowing surgeons to work around scar tissue with minimal disruption. Your specialist will consider these factors — along with your overall health and hernia type — to recommend a treatment plan tailored to your needs.

How Much Does Hernia Surgery Cost in Singapore

The surgeon’s fee for hernia surgery in Singapore varies depending on the type of hernia and the complexity of the procedure. The table below reflects MOH’s recommended fee ranges for routine and typical cases (surgeon’s fee before GST).

Hernia Type

TOSP Code

Surgeon's Fee (before GST)

Inguinal Hernia

SF819A / 3B

$3,600 – $6,000

Bilateral Hernia

SF820A / 4C

$5,600 – $9,000

Umbilical Hernia

SF814A / 3A

$3,000 – $4,900

Incisional Hernia

SF823A / 4A

$4,900 – $9,000

Femoral Hernia

SF819A / 3B

$3,600 – $6,000

Hiatal Hernia

SF701S / 5C

$9,300 – $14,700

Source: MOH Fee Benchmarks, Ministry of Health Singapore

 

Actual fees charged may differ from the benchmark ranges depending on individual patient factors, the surgical approach used, and the complexity of the case. Patients are encouraged to request a full fee breakdown from their surgeon and hospital before admission, and to check their insurance coverage in advance.

Recovery and Aftercare Following Hernia Surgery

The recovery process after hernia surgery can vary based on the type of hernia, the method of repair, and the patient’s overall health. Here are some general guidelines for recovery and aftercare:

  • Initial Rest: It’s important to rest and allow the body time to heal in the days immediately following surgery.

  • Pain Management: Patients will likely experience pain and discomfort after hernia surgery. Pain medications should be taken as directed to manage this discomfort effectively.

  • Wound Care: Keep the surgical site clean and dry. Patients will be given specific instructions on caring for their wounds, including when to shower and how to change dressings.

  • Activity Restrictions: Lifting heavy objects or engaging in strenuous activities is restricted for several weeks after surgery to prevent recurrence. Guidelines will be provided on when it is safe to return to work and other normal activities.

  • Diet: Patients are usually encouraged to eat fibre-rich foods and drink plenty of fluids to avoid constipation, which can strain the surgery site.

Dr Thng Yongxian

Senior Consultant

Hernia & General Surgeon

MBBS (SG) • MMed (Surg) • MRCS (Ire) • FRCSEd (Gen) • FAMS (Surg)

Dr Thng Yongxian is an experienced MOH-accredited general surgeon with focused expertise in ventral hernia surgery, including laparoscopic and keyhole techniques that support quicker recovery and minimal scarring. To date, he has performed more than 6,000 procedures across general and abdominal wall surgery.

  • Bachelor of Medicine & Bachelor of Surgery
  • National University of Singapore
  • Membership of the Royal College of Surgeons, Ireland
  • Master of Medicine, General Surgery, Singapore
  • Fellow of the Royal College of Surgeons, Edinburgh
  • Fellow of the Academy of Medicine, Singapore

Dr Thng Yongxian is a fellowship-trained hepatopancreatobiliary (HPB) and general surgeon and an experienced hernia surgeon providing hernia surgery in Singapore. Over his career, he has performed a wide range of patient-centered hernia treatment options, including laparoscopic hernia repair (also known as keyhole hernia surgery or minimally invasive hernia surgery) for conditions like inguinal hernia treatment and ventral hernia surgery.

 

He first honed his subspecialty expertise in HPB surgery at the Department of Hepatopancreatobiliary Surgery, Singapore General Hospital, before completing a clinical fellowship in minimally invasive HPB laparoscopic surgery at Seoul National University Hospital in South Korea. This specialist training provides a deep understanding of complex abdominal anatomy, often placing surgeons with this background among the more experienced hernia surgeons in Singapore for complex or recurrent cases. His surgical experience spans both public institutions such as the National University Health System as well as private hospitals including Mount Elizabeth, Gleneagles, and Mount Alvernia Hospital.

 

Dr Thng has been instrumental in advancing HPB surgery excellence in Singapore, pioneering his hospital’s laparoscopic HPB program and also applied these endoscopic minimally invasive techniques in managing ventral hernias and other abdominal wall conditions. His surgical techniques have been featured on live national television and presented at international surgical conferences.

Areas of Expertise
  • Minimally Invasive Hernia Surgery: Proficient in keyhole surgery for hernias, providing minimally invasive surgery for hernia as a hernia repair without open surgery option for many patients. These approaches can potentially lead to less post-operative discomfort.
  • Inguinal Hernia Repair: Provides comprehensive inguinal hernia repair surgery, including laparoscopic inguinal hernia surgery. He utilises advanced techniques for inguinal hernia repair for both straightforward and complex inguinal hernia repair, focusing on durable, low-recurrence inguinal hernia surgery.
  • Ventral Hernia Repair: Offers various ventral hernia repair techniques, including minimally invasive ventral hernia repair and minimally invasive ventral hernia treatment. He is also experienced in complex hernia repairs, including complex ventral hernia surgery, with an approach aimed at reducing pain during the ventral hernia repair process.
  • Patient-Centred Surgical Planning: Develops personalised hernia treatment plans focused on patient needs. The use of laparoscopic hernia surgery for potentially faster recovery (where applicable) is part of an overall approach aimed at minimising pain experienced during hernia treatment.
  • Advanced Surgical Approaches: Employs advanced hernia repair techniques and advanced surgical technology for hernia to achieve a secure, low-recurrence hernia surgery (low-recurrence repair) and potentially higher success rates.
Professional Appointments
  • Former Clinical Lead, HPB Division, National University Health System (NUHS)
  • Member, Ministry of Health (MOH) Laparoscopic Cholecystectomy Clinician Workgroup for Value-Driven Care (VDC)

Frequently Asked Questions About Hernia Surgery

Is hernia surgery painful?

During the hernia surgery itself, you will not feel as much pain due to anaesthesia. Afterwards, it is normal to experience some pain, soreness, or aching at the repair site. Your doctor or surgeon will ensure this post-operative discomfort is managed effectively with prescribed pain relief, and it typically improves significantly within a week.

For a small hernia that causes no symptoms, a doctor might suggest observation. However, the hernia will not heal on its own and may grow larger over time. Delaying surgery carries the risk of the hernia becoming incarcerated (trapped) or strangulated (blood supply cut off), which is a medical emergency requiring immediate treatment.

Hernia repair surgery is a common and successful surgical procedure performed in Singapore and worldwide. The goal is to provide a durable repair and relieve symptoms. Using modern techniques, including surgical mesh reinforcement, has made the procedure more reliable, though success also depends on individual patient factors.

The primary goal of hernia repair is to be permanent, but there is a small risk of recurrence. The likelihood depends on factors like the original hernia’s size, the surgical technique used, and the patient’s own tissue health. Following your surgeon’s aftercare instructions, such as avoiding heavy lifting, is important to minimise this risk.

Corporate & Personal Insurance Plans

Our Clinic Location

Precision Surgical Centre
@ Gleneagles Hospital Annexe Block

Precision Surgical Centre @ Gleneagles Hospital Annexe Block

Clinic Locations

Nexus Surgical @ Mt. Alvernia

Nexus Surgical @ Mt. Elizabeth Orchard

Nexus Surgical @ Mt. Elizabeth Novena

Nexus Surgical @ Parkway East

Nexus Surgical @ Gleneagles Medical Centre

Nexus Surgical @ Mt. Alvernia

Nexus Surgical @ Mt. Elizabeth Orchard

Nexus Surgical @ Mt. Elizabeth Novena

Nexus Surgical @ Parkway East

Nexus Surgical @ Gleneagles Medical Centre

Nexus Surgical @ Mt. Alvernia

Nexus Surgical @ Mt. Elizabeth Orchard

Nexus Surgical @ Mt. Elizabeth Novena

Nexus Surgical @ Parkway East

Nexus Surgical @ Gleneagles Medical Centre

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