Historically hernias were repaired quite liberally when they presented in order to avoid the potential serious complication of bowel being caught passing through the hernia and developing gangrene. In modern practice, a clinical decision is made by your surgeon that accounts for all risks and benefits. Benefits of repairing the hernia include reducing the chance of a serious hernia related complication (like bowel strangulation), removing or reducing the pain from a hernia, ‘normalising’ the appearance of the abdomen by fixing an unsightly and awkward lump and improving quality of life and allowing a return to more normal activities. Note a small hernia can be as much of a problem and risk than a large one (a small hole in the muscles can still allow bowel to come through and the small hole can ‘strangle’ the bowel more easily than a large hole). Risks include any small risk from surgery or the chance of creating discomfort that may not be present in the first place for a small hernia. Assessing a person’s general fitness for surgery is also another important factor that your surgeon needs to consider in whether to operate or not.