Frequently asked questions

In adults, a true hernia defect generally does not close on its own. The timing and need for surgical treatment depend on the type of hernia, symptoms and patient characteristics.

For mild, asymptomatic diastasis, a programme of functional assessment and rehabilitation may be useful. For pronounced cases or those associated with a hernia, surgical correction is generally the most effective option.

Not necessarily using the same approach or within the same timeframe. Some hernias can initially be monitored, while others require surgical treatment following specialist assessment of their location, size, symptoms and risk of complications.

The most common sign of a hernia is a bulge that becomes more noticeable during exertion. Diastasis more often presents as laxity along the midline when bending the trunk. The diagnosis should be confirmed by a surgical examination.

No. Many hernias and cases of diastasis can be diagnosed by specialist examination alone. Ultrasound or CT scans provide further information about the defect or help plan surgery.

No. In diastasis, the linea alba is widened and the rectus muscles are further apart, but there is not necessarily a hole in the abdominal wall. However, diastasis and a hernia can coexist.

The European Hernia Society guidelines define diastasis as a separation of more than 2 cm between the rectus muscles. However, the measurement alone does not determine the need for surgery.

No. The decision depends on symptoms, functional impact, the characteristics of the abdominal wall and the presence of any associated hernias.

In some patients, it can improve abdominal wall control and function. The guidelines suggest that it may be considered before surgery, but it does not replace the effectiveness of surgery.

When they coexist, both must be considered during planning. A single midline reconstruction that also includes hernia repair can be planned.

Yes. Rectus diastasis can also affect men and may be associated with umbilical or epigastric hernias.

In adults, a true fascial defect generally does not tend to close on its own. However, the need for surgery and its timing are determined individually.

Many hernias remain stable or cause few symptoms, but complications such as incarceration or strangulation can occur. A sudden change with severe pain and inability to reduce the hernia requires urgent assessment.

No. An umbilical hernia is a true defect in the abdominal wall, whereas in diastasis the linea alba is widened and thinned. However, the two conditions can be present at the same time.

No. Many umbilical hernias can be diagnosed clinically. Ultrasound or CT scans are used when additional information about the anatomy of the defect is needed or to plan surgery.

Recurrence is possible after any surgical technique. The risk depends on multiple factors related to the defect, the patient and the repair performed.

Yes. When an umbilical hernia and diastasis coexist and both require correction, combined treatment of the midline must be planned.

No. In adults, the defect in the linea alba does not tend to close on its own. The need for surgery and its timing are determined by symptoms, the anatomy of the defect and patient characteristics.

It depends on the symptoms, size and contents of the hernia. Any activity that causes pain or increased swelling should be reassessed. Following examination, personalised advice can be provided on exercises that are suitable in the interim.

Lifting weights increases abdominal pressure and can make the defect more noticeable or symptomatic. However, it is not possible to predict how the hernia will progress solely on the basis of the weight lifted.

A hernia may be associated with a localised swelling that increases with coughing or exertion. The diagnosis is confirmed by surgical examination and, where appropriate, dynamic ultrasound of the abdominal wall.

No. An epigastric hernia is a true defect in the linea alba, whereas diastasis is a widening and thinning of the midline. However, the two conditions can coexist.

The decision depends on the size and number of defects, the presence of diastasis, tissue quality, any recurrence and the patient's general characteristics.

No. Many epigastric hernias are diagnosed clinically. Ultrasound is useful for small or uncertain defects, while CT is mainly used in complex cases, recurrences or when planning extensive reconstructions.

The return depends on the repair performed. Light activities can be resumed earlier, while weights and strenuous exercise require a gradual progression agreed with the surgeon. After midline reconstructions, a return to full exertion can be planned at around 90 days.

No. In adults, the defect does not close on its own. The need for surgery and its timing depend on symptoms and patient characteristics.

It depends on pain, size, reducibility and the type of activity. Exercises that cause pain or increased bulging should be adapted following assessment.

Lifting temporarily increases abdominal pressure and can worsen symptoms and increase the size of the hernia.

No. In patients who play sport, pain may arise from muscles, tendons, the hip, athletic pubalgia or other conditions. An examination helps identify the cause.

In adults, most repairs involve prosthetic reinforcement. The technique and type of mesh are chosen according to the patient and the operation.

No. Many hernias are diagnosed clinically. Investigations are useful when the clinical picture is uncertain, the bulge is not obvious or other causes of pain need to be excluded.

Yes. In patients with bilateral hernias, a laparoscopic or robotic approach generally allows both sides to be treated during the same operation.

It depends on the technique, the type of hernia and the sport practised. Light activity can be resumed earlier, while intensive running, abdominal exercises and weights should be reintroduced gradually following review.

Yes. These are two terms used to describe the same hernia, which passes through the femoral canal.

Femoral hernias account for a minority of groin hernias overall, but are particularly important in women; the guidelines therefore recommend specifically considering them in the differential diagnosis of groin swellings in women.

Yes. Pain in the groin and upper thigh may originate from muscles, tendons or joints, but can also be due to a small femoral defect; diagnosis requires clinical assessment and, where appropriate, dynamic imaging.

No. The anatomical defect does not close on its own.

No. Some femoral hernias are small and deep and may present mainly with pain.

A femoral hernia passes through the femoral canal and lies lower than an inguinal hernia. Examination and dynamic ultrasound can help in uncertain cases.

Yes. The guidelines recommend a laparo-endoscopic approach for femoral hernia repair when appropriate expertise is available.

For elective femoral hernia repair, the guidelines always recommend mesh repair.

Because the femoral canal is narrow and the hernia contents can become incarcerated; sudden pain, inability to reduce the hernia, nausea or vomiting require prompt medical assessment.

Yes. An incisional hernia is a hernia that develops at a previous abdominal surgical scar.

No. The abdominal wall defect does not close on its own; treatment is surgical.

Yes, the prosthesis is needed to reinforce the abdominal wall and reduce the risk of recurrence.

Yes. Laparoscopic or robotic surgery can be used depending on the defect and patient characteristics.

You should seek prompt medical attention if an incisional hernia suddenly becomes painful, hard, irreducible or associated with nausea, vomiting, fever or abdominal distension.

Yes. In some patients, the defect may progressively enlarge and become more noticeable or symptomatic.

When the two conditions coexist, the strategy involves comprehensive reconstruction of the midline and abdominal wall.

Both use small surgical access incisions and a camera. In laparoscopy, the surgeon directly manipulates rigid instruments, whereas in robotic surgery the surgeon uses a console to control articulated instruments with three-dimensional vision. The choice depends on the type and complexity of the operation.

In many procedures, particularly abdominal wall surgery, smaller incisions and less dissection of superficial tissues can reduce wound complications and the risk of surgical site infection compared with large open incisions.

Yes. Many inguinal, femoral, umbilical and epigastric hernias, as well as various incisional hernias and defects associated with diastasis, can be treated using minimally invasive approaches. The technique is chosen according to location, size, previous operations and abdominal wall characteristics.

The main techniques include TAPP, TEP, eTEP, peTEP, miSAR®/p-miSAR® and TAR/r-TAR. These procedures are not interchangeable: each uses different anatomical planes and reconstructive principles and must be selected according to the individual defect.

No. The robot does not perform the operation autonomously. All instrument movements are controlled in real time by the surgeon through the console.

Yes. Laparoscopy can be used, for example, for appendicitis, cholecystitis, some bowel obstructions, incarcerated or strangulated hernias and some bowel perforations. However, the feasibility of a minimally invasive approach depends on the patient's clinical condition and the severity of the presentation.

Laparoscopic surgery uses small access incisions through which a camera and surgical instruments are introduced. Conventional surgery generally requires a larger incision. Both have specific indications, and the choice depends on the condition.

Yes, it causes less postoperative pain because surgical access involves less trauma.

For selected patients and procedures, anaesthetic techniques that do not require tracheal intubation may be considered. The decision rests with the anaesthetist, who considers the duration of surgery, ventilation requirements, aspiration risk and airway safety.

Some selected procedures allow same-day discharge. Others require one or more nights in hospital, while major and emergency surgery may require longer stays.

Yes, laparoscopy can allow the hernia to be reduced and bowel viability to be assessed.

No. Smaller incisions reduce some wound complications compared with open surgery, but do not completely eliminate the risk of infections or hernias at access sites.

Yes, it can be used for many tumours of the colon and rectum. The choice must always ensure adherence to the principles of oncological surgery.

No. The robot is a platform controlled entirely by the surgeon. Every instrument movement derives from commands given at the console.

Both are minimally invasive techniques, but they use different instruments. In laparoscopy, the surgeon moves the instruments directly; in robotic surgery, the surgeon controls them through a console.

No. The choice depends on the procedure and the patient. Laparoscopy is entirely appropriate for many operations; robotic surgery may offer technical advantages particularly in procedures requiring complex dissection and reconstruction.

Yes. Inguinal and ventral hernias, incisional hernias, rectus diastasis associated with hernias and selected complex defects can be treated through a robotic approach in appropriately selected patients.

Operations are generally performed through small trocar access points. The number and position of the incisions depend on the procedure.

Yes, mesh may also be used in robotic hernia surgery.

Not exactly. The patient is formally admitted, undergoes surgery and is observed after the operation, but is discharged on the same day if their clinical condition allows it.

No. Laparoscopic and robotic surgery can support a rapid recovery, but same-day discharge depends on the type of procedure, the patient's condition and their postoperative progress.

Yes, in selected patients. Some inguinal hernia repairs performed using laparoscopic or robotic TAPP techniques can be scheduled as Day Surgery.

Yes, in selected cases. The TAPP technique can also repair a femoral defect through a minimally invasive approach.

Generally not in the hours immediately following anaesthesia. Someone must accompany you when you are discharged, and you should follow the instructions provided by the clinical team.

No. Discharge only takes place when the safety criteria have been met. If necessary, observation can be extended or the patient can be admitted to hospital.

Not when it is used for correctly selected patients and procedures. Safety depends on preoperative selection, anaesthetic management, the operation and postoperative monitoring.

Because conditions such as smoking, uncontrolled diabetes, excess weight and other comorbidities can increase perioperative risk and impair healing. Where possible, they are therefore corrected before surgery.

Not always. It depends on BMI, fat distribution, the type of defect and the planned operation. When indicated, the patient may be supported by nutritionists and endocrinologists before surgery.

Yes, in selected patients. Abdominoplasty, mini-abdominoplasty, liposuction or other procedures may be combined when clinically appropriate and planned in advance with the plastic surgeon.

After many abdominal wall reconstructions, the structured programme can begin around day 50, but timing is personalised according to the operation and healing.

Because surgery corrects anatomy, while rehabilitation helps the abdominal wall recover coordination, breathing, pressure control and synergy with the pelvic floor.

For abdominal wall reconstructions, it is useful to continue reviews over time. In the proposed pathway, reviews are scheduled at 6 months, 1, 2, 3 and 5 years.

No. Preparation, surgical technique, any nutritional or plastic surgery support, rehabilitation and review timing are adapted to each case.

It is the group of muscles, fascia and ligaments that supports the pelvic organs and contributes to continence, urination and defecation.

The bladder, vaginal walls, uterus or vaginal vault, rectum and, in some cases, the small bowel may be involved.

A rectocele is a bulging of the rectal wall towards the vagina; in rectal prolapse the rectum descends towards the anal canal and may protrude externally.

Yes. Some patients have evacuation difficulty caused by anatomical changes, muscular dyssynergia or both.

No. Initial treatment is often conservative and rehabilitative; surgery is considered in selected patients with significant anatomical abnormalities and persistent symptoms.

No. Treatment depends on the severity of symptoms and their impact on quality of life. Some forms can be monitored or treated conservatively.

Yes. Rectal prolapse may be associated with reduced continence, mucus discharge and evacuation difficulty.

Depending on symptoms, defecography MRI, anorectal manometry, endoanal ultrasound, proctoscopy or colonoscopy may be indicated.

In many selected cases, yes. Some suspension procedures can be performed laparoscopically or robotically.

No. They can cause similar symptoms, but they are different anatomical conditions and require an accurate diagnosis.

General surgery covers many conditions of the abdomen and digestive tract, as well as conditions of the thyroid, abdominal wall, pelvic floor and anorectal region.

No. Whether laparoscopy can be used depends on the condition, the complexity of the operation, previous surgery and the patient’s condition.

Both use small abdominal access points. In laparoscopic surgery the surgeon handles the instruments directly, whereas in robotic surgery the surgeon controls articulated instruments from a console.

Yes. Appendicitis, cholecystitis, bowel obstruction, perforation and complicated hernias are some of the conditions that may require urgent surgical assessment.

The decision is based on symptoms, diagnosis, imaging and other investigations, medical history and the balance between the benefits and risks of surgery.

No. Asymptomatic gallstones are not automatically an indication for surgery. The decision depends on symptoms and on the patient's clinical characteristics.

The most typical symptom is biliary colic, characterised by pain in the upper abdomen, often associated with nausea or vomiting.

When surgery is indicated, it is not just the stones that are removed: the gallbladder itself is removed through an operation called cholecystectomy.

Yes. Laparoscopic cholecystectomy is performed through small abdominal access points, except in situations where a different approach is required.

Yes. The liver continues to produce bile, which reaches the intestine directly through the bile ducts.

Yes. Acute cholecystitis may require hospital admission and surgical treatment during the acute episode, depending on the patient's clinical condition.

Severe and persistent pain, fever, jaundice, significant vomiting or a deterioration in general condition require prompt medical assessment.

No. Many conditions are treated with medical therapy, endoscopy or observation.

No. Many episodes are treated without surgery. Surgery is considered when complications are present or in selected situations.

In many patients, yes, when the approach allows the operation to be performed safely and in accordance with oncological principles.

Yes, some operations can be performed with robotic surgery.

There is no single best technique. The choice depends on the condition, the anatomy and the type of operation.

In selected patients, yes, when the clinical and anatomical conditions allow a safe minimally invasive approach.

In some selected cases, yes, provided it does not delay the necessary treatment.

The most common include appendicitis, acute cholecystitis, bowel obstruction, incarcerated or strangulated hernia, gastrointestinal perforation and complicated diverticulitis.

Yes. Many abdominal emergencies can be treated laparoscopically in selected patients, when clinical and anatomical conditions allow.

Yes. Appendicectomy can be performed laparoscopically in many patients.

Yes. When surgery is indicated, cholecystectomy can be performed with a laparoscopic approach in many patients.

Strangulation can compromise the blood supply to the contents of the hernia and requires urgent surgical assessment.

In some selected cases, yes, provided its use does not delay the necessary treatment.

Very severe or worsening pain, persistent vomiting, marked abdominal distension, significant bleeding, a serious general deterioration or other major acute symptoms require urgent assessment.

miSAR® stands for Minimally Invasive Stapled Abdominal Reconstruction, meaning minimally invasive abdominal reconstruction using mechanical suturing.

Yes. The technique was developed specifically to reconstruct the midline, bringing the rectus muscles closer together and treating any associated hernia defects at the same time.

The reconstruction is generally reinforced with a prosthesis placed in the retromuscular space, keeping it separate from the abdominal viscera.

p-miSAR® retains the principles of miSAR® but is performed through an extraperitoneal approach, avoiding entry into the peritoneal cavity whenever possible.

Yes. It can be performed laparoscopically or robotically according to the anatomy and complexity of the case.

No. The indication depends on defect size, anatomy, BMI, previous operations, the presence of hernias or incisional hernias and the patient’s goals.

In selected patients, the stay can be short, often one night. The programme is nevertheless determined according to the operation and clinical condition.

Approximately around day 50, following clinical assessment and according to the type of reconstruction performed.