Ventral Hernia Surgery in Punjab: Epigastric, Paraumbilical, Spigelian and Other Belly Wall Hernias

Last updated 2026-11-08 · Medically reviewed by Dr Raman Garg · Punjab, India

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A ventral hernia is any hernia through the front wall of your belly, outside the groin. It includes epigastric (above the navel), paraumbilical (at or beside the navel), spigelian (on the side) and primary ventral hernias. Dr Raman Garg, laparoscopic hernia surgeon at Bombay Gastro & Cancer Institute, Bathinda, Punjab, India, repairs them with mesh, mostly by keyhole.

20+ years | 10,000+ laparoscopic surgeries | 1,000+ hernia repairs | Cashless insurance | OPD Mon to Sat 10 AM to 5 PM

What is a ventral hernia? (pet ka hernia)

"Ventral" simply means the front of the body. Your belly wall has a strong vertical band of tissue in the middle, called the linea alba, and strong muscles on each side. When a small gap opens in this wall, fat or a loop of intestine pushes through. You see or feel a lump. That lump is a ventral hernia.

Think of a cloth bag with a worn patch. The bag still holds, but the weak spot slowly bulges. Where the patch wears out decides the name of the hernia.

Body diagram description for the page image: a front view of the belly with four marked spots. One above the navel (epigastric), one at the navel edge (paraumbilical), one on the side of the rectus muscle (spigelian) and a long scar line (incisional, linked to its own page).

The four types we treat most often are covered in the next section. If your hernia sits on an old operation scar, read our page on incisional hernia surgery. For a navel hernia that is small and simple, see umbilical hernia surgery.

The types: epigastric, paraumbilical, spigelian and primary ventral

Epigastric hernia (hernia above the belly button)

This hernia sits in the midline between the breastbone and the navel. It usually starts as a small gap that lets a pinch of fat out. It looks like a pea or a marble under the skin and is often tender when pressed. People often mistake the pain for gas or acidity and take antacids for months. If you have "gas pain" in a fixed spot above the navel and a small lump you can feel when you lie flat and lift your head, get it checked. It is more common in men, in thin and heavy people alike, and in those who do heavy work.

Paraumbilical hernia (naabhi ke paas ka hernia)

This hernia lies at the edge of the navel, just above or below it. It is common in women after pregnancy, in people with a big belly and in those with long-term cough or constipation. The gap can be small or very wide, and the lump often grows over the years. A small one may be a pea, a wide one may hold a loop of intestine and look like a fist. Many people call it "belly button hernia" or "naabhi ka hernia".

Spigelian hernia (on the side of the belly)

This rare hernia shows up on the lower side of the belly, along the outer edge of the straight muscle. Because it sits below the muscle layer, the swelling may not be easy to see. People feel a dull ache or a deep pull on one side, and many are told it is a muscle strain or gas. An ultrasound or CT scan is often needed to find it. Spigelian hernias have a narrow neck, so they carry a higher chance of the bowel getting trapped. This makes early repair sensible.

Primary ventral hernia

This is a hernia in the belly wall that does not sit at the navel, on the scar or at the side. It may be a small gap in the midline or in the lower belly. Doctors call it a primary ventral hernia when it appears without any earlier surgery.

All four are repaired on similar principles, and this is why they share a page.

Who gets it and what causes it

A ventral hernia is a result of strain on a weak spot. Common causes and risk factors:

• Pregnancy, especially more than one, that stretches the belly wall.
• Obesity and a large belly.
• Heavy lifting in farm work, labour, loading or gym training.
• Long-term cough, constipation or straining to pass urine.
• Smoking and tobacco, which weaken healing tissue.
• Rapid weight gain or loss.
• Family tendency, as some people simply have weaker connective tissue.
• Fluid in the belly (ascites) from liver disease, which needs separate care.

A Bathinda shopkeeper with a rising belly, a farmer who lifts bags of grain and a woman after her third delivery are classic examples. Most patients are between 30 and 65.

Symptoms and when to worry

• A lump on the belly that grows when you stand, cough or strain.
• Pain or tenderness at the lump, worse after meals, lifting or long standing.
• A pulling or burning feeling in one spot.
• Pain above the navel that your doctor says is gas, but does not go with antacids.
• A lump that you can push back in lying down.

When to worry. Go to a hospital the same day if the lump turns hard and will not go back, the pain is sudden and severe, you vomit, you have fever, the skin turns red, or you pass no gas or stool. Call +91 82641-60001, our 24/7 emergency care support. See also emergency hernia surgery.

How Dr Raman Garg diagnoses a ventral hernia

Dr Raman Garg examines you standing and lying, and asks you to cough or raise your head. Most epigastric and paraumbilical hernias are confirmed by touch. He then advises tests based on the type:

• Ultrasound shows the gap and its contents, and is useful for small epigastric and spigelian hernias.
• CT scan is advised for spigelian hernias, wide gaps, multiple defects and larger hernias. It measures the gap and helps plan the mesh.
• Blood tests, ECG and chest X-ray to check you are fit for surgery.

You can send photos and old reports on WhatsApp to +91 82641-60001 before you travel.

Note: These are typical Punjab costs for 2026. The final cost may vary after Dr Raman Garg examines you, depending on the hernia type, size, number of sides, mesh used and your health.

Treatment options: without surgery and with surgery

A ventral hernia is a gap in the belly wall. It does not close with medicine, massage, exercise or desi ilaj. If you are searching "hernia bina operation theek hota hai kya", the honest answer is no. A hernia belt gives short-term comfort only, as explained in our blog on whether a hernia belt works.

When surgery can wait: a tiny, painless epigastric hernia with no growth, in a patient with other health problems, may be watched with checks. Stop smoking, control weight and avoid heavy lifting.

When surgery is advised: the lump hurts, is growing, has a narrow neck, is a spigelian hernia, or is wide enough to hold intestine. Mesh repair is standard. Repair with stitches alone is used only for the smallest gaps, and the gap can come back more often. You can read about the mesh in our page on mesh hernia repair.

Dr Raman Garg decides the method after the examination and scan. See also laparoscopic hernia surgery.

The operation step by step

Most keyhole ventral hernia repairs follow this path:

• Anaesthesia. General anaesthesia, with an anaesthetist present throughout.
• Three small cuts of about 5 to 10 mm are made on the side of the belly. A camera and thin tools pass through them.
• Reduction. Fat or gut inside the hernia sac is gently pulled back into the belly.
• Measuring. The gap is measured from inside, and a mesh is chosen to overlap the gap by about 4 to 5 cm all around.
• Closing the gap with strong sutures where possible, so the bulge goes and the mesh lies on a flat surface.
• Mesh placement. A composite mesh, coated on the gut side, is laid over the closed gap and fixed in place.
• Skin glue. The small cuts are closed with skin glue, so there is no stitch removal visit.

Time in theatre is typically 45 to 90 minutes for a single paraumbilical or epigastric repair. Wider gaps, multiple defects or adhesions take longer. In small epigastric hernias, an open cut of 3 to 5 cm may be used. In open repair, one 6 to 8 cm cut is used for bigger hernias, with 1 to 2 days in hospital.

Before surgery checklist

• Stop smoking and tobacco 4 weeks before surgery.
• Bring earlier reports, scans and a list of your medicines.
• Tell us about blood thinners, diabetes, BP and thyroid medicines.
• Treat cough, constipation or urine trouble before the date.
• Fast as advised by the anaesthetist.
• Keep insurance papers and ID ready.
• Arrange one family member to stay with you.

Day of surgery timeline

Recovery timeline

Open repair: desk work in 2 to 3 weeks. A small lump or ridge at the mesh for some weeks is normal. Follow-up is by phone or video. More is on our hernia surgery recovery page.

Risks and how they are handled

• Seroma (fluid pocket) near the mesh. Common, usually settles on its own.
• Infection. Lowered by clean technique, timely antibiotics and good sugar control.
• Pain at the mesh edge for a few weeks.
• Bowel injury or bleeding. Rare. This is why an experienced laparoscopic surgeon matters.
• Hernia coming back. No method removes this risk fully. Mesh, weight control, no smoking and a slow return to heavy work lower it.

Dr Raman Garg explains every risk that applies to you before you sign consent.

Ventral hernia surgery cost in Punjab

Note: These are typical Punjab costs for 2026. The final cost may vary after Dr Raman Garg examines you, depending on the hernia type, size, number of sides, mesh used and your health.

Spigelian hernia repair is typically priced within the epigastric or ventral row. Keyhole repair costs more than open repair because of the equipment and the mesh, but you return to work 1 to 2 weeks earlier. Published ranges from Mohali and Chandigarh hospitals are in the same band for laparoscopic repair, and metro hospitals often charge more. See the full table on hernia surgery cost in Punjab.

Insurance and cashless treatment

BGCI is empanelled with almost all major insurers and TPAs for cashless treatment: Aditya Birla Health Insurance, Niva Bupa, Digit Insurance, Care Health Insurance, Vidal Health TPA, ICICI Lombard, Raksha TPA, Future Generali, SBI General Insurance, Oriental Insurance, Liberty General Insurance, IFFCO Tokio, Cholamandalam MS, Medi Assist TPA, and almost all other major insurers and TPAs.

• Send your card and reports on WhatsApp or bring them to OPD.
• Our insurance desk checks your cover and sends the pre-authorisation request.
• The insurer approves before admission, in most cases.
• After surgery, the approved amount is settled directly with the insurer.

Ayushman Bharat: call us with your card details and our insurance desk will tell you the same day how your card can be used. See hernia surgery insurance.

Facilities at BGCI

A good hernia hospital should have a modern laparoscopic theatre, an experienced anaesthetist, an in-house lab, emergency backup and a cashless desk. BGCI covers all of these:

• Modern laparoscopic operation theatre with high-definition imaging.
• Advanced endoscopy and colonoscopy suite, to check for gut causes of upper belly pain before surgery.
• Fully equipped in-house diagnostic laboratory with same-day reports.
• Comfortable patient rooms for you and your family.
• 24/7 emergency care support on +91 82641-60001.
• Cashless insurance desk for pre-authorisation.
• Stitchless laparoscopic technique with skin glue, with no stitch removal visit.
• Same-day walking and discharge within 24 hours for most keyhole repairs.
• One surgeon from consultation to follow-up.
• Online pre-arrival consultation for NRI and out-of-town patients, with follow-up by phone or video.

Read more on our hernia hospital page.

Why patients choose Dr Raman Garg

Dr Raman Garg is a Surgical Gastroenterologist and Laparoscopic Hernia Surgeon with 20+ years of experience, 10,000+ laparoscopic surgeries and 1,000+ laparoscopic hernia repairs. He is one of the leading hernia surgeons in Punjab. Patients come from all Punjab districts, Haryana, Rajasthan and abroad.

He holds an MBBS from Government Medical College, Patiala; MS General Surgery from Dayanand Medical College & Hospital, Ludhiana; DNB Surgical Gastroenterology from Lilavati Hospital and Research Centre, Mumbai; a Fellowship in Advanced Laparoscopic Surgery; and advanced laparoscopy training in Seoul, South Korea. He is registered with the Dubai Health Authority as Physician Specialist, Gastrointestinal Surgery, and is a member of IAGES and AMASI. He was among the first surgeons in Bathinda to perform laparoscopic inguinal hernia surgery and complex hiatus hernia surgery, and is the first surgical gastroenterologist in the Malwa belt of Punjab.

Because he is a gastro surgeon too, he is careful to rule out gut causes when you have upper belly pain with an epigastric lump. See his full profile at Dr Raman Garg.

Patients we see from your area

Patients with ventral hernias reach BGCI from Talwandi Sabo (about 30 km, 45 min), Mansa (about 50 km, 1 hr), Giddarbaha (about 45 km, 1 hr), Kotkapura (about 45 km, 1 hr), Muktsar (about 55 km, 1 hr 10 min), Faridkot (about 65 km, 1 hr 20 min), Barnala (about 70 km, 1 hr 30 min), Sirsa (about 95 km, 2 hr), Abohar (about 105 km, 2 hr) and Patiala (about 125 km, 2 hr 30 min). We also see patients from Dabwali, Hanumangarh, Sri Ganganagar, Fazilka, Firozpur and Amritsar. See all on areas we serve.

You can come by road, by bus from the main bus stand, or by train to Bathinda Junction. Send your reports on WhatsApp first and save a trip.

How to book

• Call or WhatsApp +91 82641-60001 or +91 99885-03800.
• Send a photo of the lump and any scan.
• Pick a day. OPD is Monday to Saturday, 10 AM to 5 PM. Sunday is emergency only.
• Meet Dr Raman Garg, then plan tests and surgery.
• The insurance desk handles pre-authorisation.

Address: Bombay Gastro & Cancer Institute (BGCI), Power House Road, Near Street No. 10, Bathinda, Punjab 151001, India. Phone and WhatsApp: +91 82641-60001 | +91 99885-03800 Email: bgcibathinda@gmail.com Emergency: 24/7 emergency care support, call +91 82641-60001.

Book online on book appointment. Local patients: hernia surgery in Bathinda.

Related pages

• Hernia surgery in Punjab, our main hub
• Incisional hernia surgery for hernia on a surgery scar
• Umbilical hernia surgery for navel hernia
• Recurrent hernia surgery if the hernia came back
• Blog: umbilical hernia after pregnancy

Medically reviewed by Dr Raman Garg Last updated: 8 November 2026

This page is general information; your plan is set after Dr Raman Garg examines you.