United Kingdom
Change

Support and offers for individual members and customers

Health Information

Inguinal hernia repair

Published by Bupa's health information team, August 2008.

This factsheet is for people who are planning to have an inguinal hernia repair operation, or who would like information about it.

Inguinal hernia repair involves pushing the hernia back into the abdomen (tummy) and repairing the weakened muscle.

Your care will be adapted to meet your individual needs and may differ from what is described here. So it's important that you follow your surgeon's advice.

About inguinal hernia repair
Diagnosis
Preparing for your operation
About the operation
Animation - How open inguinal hernia repair surgery is carried out
Animation - How keyhole inguinal hernia repair surgery is carried out
What to expect afterwards
Recovering from inguinal hernia repair
What are the risks?
Questions and answers
Related topics
Further information
Sources

About inguinal hernia repair

An inguinal hernia is a lump in the groin that occurs when part of your gut (intestine) pushes through a weakness in the muscles of the abdominal wall.

Inguinal hernias are most common in boys and men. They may be present at birth or develop later in life. Straining, heavy lifting, coughing or being overweight increases the pressure within the abdomen, and this puts strain on the muscles in the groin area.

A hernia isn't dangerous in itself, but if it isn't treated it's likely to get larger and become more uncomfortable. There is a risk that the gut will get trapped inside cutting off the blood supply to the hernia contents (strangulation), causing life-threatening conditions such as gangrene and peritonitis. It may result in the gut becoming blocked (obstructed).

Illustration showing the position of an inguinal hernia
The position of an inguinal hernia

Diagnosis

Your GP will ask your about your symptoms and examine you. He or she may also ask you about your medical history.

If you have a swelling in your groin that appears when you stand up, lift or strain, you may have a hernia. Your GP will usually recommend that you have an inguinal hernia repair.

Preparing for your operation

Your surgeon will explain how to prepare for your operation. For example if you smoke you will be asked to stop, as smoking increases your risk of getting a wound infection and slows your recovery.

The operation is usually done as a day case under general anaesthesia. This means you will be asleep during the operation. Alternatively you may prefer to have the surgery under local anaesthesia. This completely blocks the feeling from the area and you will stay awake during the operation. You may also be given a sedative to help you relax.

Your surgeon will advise which type of anaesthesia is most suitable for you.

If you are having general anaesthesia, you will be asked to follow fasting instructions. Typically you must not eat or drink for about six hours beforehand. However, some anaesthetists allow occasional sips of water until two hours before a general anaesthetic.

At the hospital your nurse may do some tests such as checking your heart rate and blood pressure, and testing your urine.

Your surgeon will usually ask you to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the operation and have given your permission for it to go ahead.

You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs. You may need to have an injection of an anti-clotting medicine called heparin as well as, or instead of, stockings.

About the operation

The operation takes 30 to 50 minutes depending on the technique used.

There are two main types of inguinal hernia repair - open and keyhole (laparoscopic). Your surgeon will recommend which is suitable for you.

Open surgery

Open surgery is the most common way to repair an inguinal hernia.

Once the anaesthetic has taken effect, your surgeon will make a single cut (about 5 to 10cm long) in your groin, and push the bulge back into place. He or she will usually attach a synthetic mesh over the weak spot to strengthen the wall of the abdomen, before closing the cut with dissolvable stitches.

How open inguinal hernia repair surgery is carried out

A Flash plug-in is required to view this animation.
Legal notices

Keyhole surgery

There are two techniques for keyhole surgery - transabdominal peritoneal (TAPP) and totally extraperitoneal (TEP).

In a TAPP operation the mesh is inserted through the lining of your abdomen (peritoneum). TEP is a newer technique where the mesh is attached without cutting through your peritoneum. This is a more difficult operation but reduces the risk of damage to the organs in your abdomen.

For both of these techniques about two or three small cuts (1 to 2cm long) are made on your lower abdomen and groin under general anaesthesia. Your surgeon will insert a tube-like telescopic camera (laparoscope) to view your hernia by looking at a monitor. After your hernia is repaired your surgeon will close the cuts in your skin with dissolvable stitches.

How keyhole inguinal hernia repair surgery is carried out

A Flash plug-in is required to view this animation.

Legal notices

What to expect afterwards

You will need to rest until the effects of the anaesthetic have passed.

You may need pain relief to help with any discomfort as the anaesthetic wears off.

You will usually be able to go home when you feel ready.

You will need to arrange for someone to drive you home. You should try to have a friend or relative stay with you for the first 24 hours.

Your nurse will give you some advice about caring for your healing wound before you go home. You may be given a date for a follow-up appointment.

Dissolvable stitches will disappear in seven to 10 days on their own.

Recovering from inguinal hernia repair

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

General anaesthesia or sedatives temporarily affect your coordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 48 hours afterwards. If you are in any doubt about driving, always follow your doctor/surgeon's advice and please contact your motor insurer so that you are aware of their recommendations.

You will need to take it easy for the first two to three days. You should be able to resume normal activities two weeks after your operation.

You may experience some discomfort in your groin area for a few weeks after the operation, but this will gradually settle and can be helped by wearing close-fitting underwear.

After the operation, you should eat plenty of vegetables, fruit and high fibre foods such as brown rice and wholemeal bread and pasta. This helps to prevent constipation, which can cause straining of the wound and discomfort.

What are the risks?

Inguinal hernia repair is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this operation.

Side-effects

These are the unwanted, but mostly temporary effects of a successful treatment, for example feeling sick as a result of the general anaesthetic.

Side-effects of inguinal hernia repair may include:

difficulty in passing urine
pain, numbness, swelling or bruising in the abdomen and groin area
for men, some scrotal swelling for a few days

These side-effects can be milder after key-hole surgery, and usually clear up during the first week, without further treatment.

Complications

This is when problems occur during or after the operation. Most people are not affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT).

Other complications specific to inguinal hernia repair are listed here.

Rarely, blood or fluid will build up in the space left by the hernia. This will usually resolve itself but you may need to have further treatment to drain the fluid.
In men, painful swelling of the scrotum or testicles occasionally occurs. This may require further surgery.
Very rarely, other tissues in the abdomen are damaged during surgery.
Pain or numbness in your groin area can continue for up to one year after the operation. If this is caused by an irritated nerve you may need another operation to treat it.
The inguinal hernia may re-occur, although this risk is reduced when using a mesh to repair the hernia.

There's a chance your surgeon may need to convert your keyhole operation to open surgery. This means making a bigger cut on your groin. This is only done if it's impossible to complete the operation safely using the keyhole technique.

The exact risks are specific to you and will differ for every person, so we have not included statistics here. Ask your surgeon to explain how these risks apply to you.