Second-row Luke Charteris (shoulder) and utility back Ceri Sweeney (groin) could return from injury for the Gwent side, along with ex-Wales wing Gareth Wyatt (shoulder).
Italy looked to have genuine claims for an infringement when Bergamasco powered down the wing only to be shoulder-charged by Southwell, earning his 50th cap along with Chris Cusiter, after kicking ahead.
Hook will undergo his surgery after facing the Springboks and Newport Gwent Dragon Will Harries has been called into the squad to replace wing Williams who also has shoulder problems.