A general surgeon is the doctor who performs most hernia repairs. General surgeons are trained to operate on hernias in the groin, belly button, and abdominal wall, and they handle the vast majority of these procedures in both planned and emergency settings. Depending on the hernia’s location, size, and complexity, other surgical specialists may be involved.
General Surgeons Handle Most Hernias
General surgery is the core specialty for hernia repair. Inguinal hernias (the most common type, occurring in the groin), umbilical hernias, and incisional hernias from previous surgeries all fall under a general surgeon’s scope. These surgeons complete at least five years of residency training, then pass both a written and oral board certification exam through the American Board of Surgery.
General surgeons perform both open and minimally invasive hernia repairs. In open surgery, a single incision is made over the hernia site, the protruding tissue is pushed back into place, and the weakened muscle is reinforced with synthetic mesh. In laparoscopic or robotic repairs, the surgeon works through several small incisions using a tiny camera and specialized instruments. At major academic centers like UCSF, the surgeons performing robotic and laparoscopic hernia repairs are almost all from the division of general surgery, often with additional expertise in minimally invasive techniques.
Not every hernia needs surgery right away. If a hernia is small and painless, your doctor may recommend watchful waiting. Surgery is typically recommended when the hernia is growing, causing pain, or poses a risk of complications.
When Other Specialists Get Involved
Certain hernias call for a surgeon with more specialized training. Hiatal hernias, which occur where the stomach pushes up through the diaphragm, may be treated by a thoracic surgeon or a surgeon who specializes in gastrointestinal procedures rather than a standard general surgeon. At Mayo Clinic, hiatal hernia care spans multiple departments including gastroenterology, thoracic surgery, and metabolic and abdominal wall reconstructive surgery.
For large or recurrent hernias where the abdominal wall has lost structural integrity, plastic surgeons increasingly play a role. These cases, sometimes called abdominal wall reconstruction, go beyond a straightforward mesh repair. They require techniques to rebuild the muscle and tissue layers of the abdomen, and a plastic or reconstructive surgeon may work alongside a general surgeon to get the best result.
A relatively new development is the hernia and abdominal wall surgery fellowship. The American Hernia Society and the Society of American Gastrointestinal and Endoscopic Surgeons created this additional year of training specifically because hernia disease has grown more complex. Fellows in these programs complete well over 100 hernia cases during their training year. If you have a complicated or recurring hernia, a fellowship-trained surgeon brings extra specialization beyond standard general surgery residency.
Hernias in Children
Children with hernias, particularly those five years old or younger, should be treated by a pediatric surgeon. This is especially important for infants born prematurely or children with conditions that increase surgical risk, such as congenital heart disease. Pediatric surgeons have completed additional fellowship training focused on operating on smaller bodies with different anesthesia needs.
General surgeons can operate on older children in some cases, but guidelines from Stony Brook University’s surgical standards recommend they should have completed at least six months of pediatric surgical training during residency and maintain enough pediatric case volume each year to stay proficient.
How You Get From Diagnosis to Surgeon
The process usually starts with your primary care doctor. A physical exam is often all that’s needed to diagnose a hernia, particularly in the groin. Your doctor will look and feel for a bulge while you stand, cough, or strain. If the hernia isn’t obvious on exam, an ultrasound, CT scan, or MRI can confirm it. From there, your primary care doctor refers you to a surgeon.
One exception is a strangulated hernia, where trapped tissue loses its blood supply. This is a surgical emergency. You won’t go through a referral process. The general surgeon on call at the hospital will perform the repair, which may include removing a section of damaged bowel if the tissue has been without blood flow too long.
How to Choose the Right Surgeon
For a straightforward inguinal or umbilical hernia, a board-certified general surgeon with regular hernia volume is a solid choice. For complex situations, such as a hernia that has come back after a previous repair, a very large hernia, or one requiring abdominal wall reconstruction, look for a surgeon with specific experience in those cases.
During a consultation, the National Health Council recommends asking a few pointed questions: how many hernia repairs the surgeon performs each year, what their recurrence and complication rates look like, and whether they have experience with your specific type of hernia. A surgeon who does dozens or hundreds of hernia repairs annually will generally have better outcomes than one who does a handful. You can also ask whether they offer both open and minimally invasive options, since laparoscopic repair isn’t always appropriate. Very large hernias or patients with prior pelvic surgery may not be good candidates for the minimally invasive approach.
Board certification through the American Board of Surgery confirms a surgeon has met national standards for training and passed rigorous exams. You can verify this on the ABS website. If your hernia is complex, look for surgeons affiliated with a hernia center or those who completed an abdominal wall surgery fellowship for the highest level of specialization available.