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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 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.

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.

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.

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 dual 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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How Hernias are Diagnosed

Diagnosing a hernia typically begins with a consultation with a doctor or hernia specialist. The process is usually straightforward and involves one or both of the following steps:

  • Physical examination by a surgeon

    A surgeon can often diagnose a hernia during a physical exam. The doctor will check for a bulge in the affected area and may ask you to cough or strain.

  • Imaging (when needed)

    If the diagnosis is uncertain or to check for complications, your specialist may recommend imaging. An ultrasound, CT scan, or MRI can provide a clearer view of the hernia.

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.

  • 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.

  • 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.

  • 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.

  • Emergency Hernia Surgery

    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.
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.

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.

The Hernia Surgery Procedure

1. Preparation and Anaesthesia Administration

The patient is prepared for surgery, which includes cleaning the skin over the hernia site. General anaesthesia is administered to ensure the patient remains unconscious and free from pain during the procedure.

2. Making the Incision

Open Surgery: A single, larger incision is made near the hernia site to directly access the weakened area.

 

Laparoscopic Surgery: Several small incisions are made in the abdomen to insert the laparoscope and surgical instruments.

3. Hernia Identification and Isolation

The hernia sac containing the protruding tissue is identified and isolated from the surrounding tissues.

4. Hernia Reduction

The contents of the hernia sac are carefully pushed back into their correct position within the abdomen.

5. Repairing the Hernia

The weakened area of muscle or tissue is repaired. This is typically done by sewing the edges of healthy muscle tissue together. In many cases, a mesh material is placed over the repair site to reinforce the area and prevent recurrence.

6. Checking for Complete Repair

The surgical area is examined to ensure that the hernia has been adequately repaired and that the mesh, if used, is securely in place.

7. Closure of the Incision

Open Surgery: The initial incision is closed with sutures or surgical staples.

 

Laparoscopic Surgery: The small incisions are closed with sutures, staples, or surgical glue.

8. Dressing and Bandaging

A sterile dressing is applied to the incision sites to protect them against infection and to absorb any minor bleeding that might occur.

9. Postoperative Instructions

The patient is given detailed instructions on how to care for the incision sites, on signs of infection to watch out for, and on activities to avoid during recovery. Instructions for follow-up visits and pain management are also provided.

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 dual 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

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

Need help navigating your health?

If you’re experiencing symptoms or want to understand your treatment options, contact us today.