Is laparoscopic surgery better than open surgery?

Both techniques are highly effective. Laparoscopic surgery may offer a faster recovery and less post-operative pain, and is often preferred for bilateral or recurrent hernias. Open surgery is a very well-established, reliable technique. Your surgeon will recommend the best approach for you based on your individual circumstances.

How long will I be off work?

This depends on your job. For office-based or sedentary work, most patients can return within one to two weeks. For jobs involving manual labour or heavy lifting, a longer recovery of four to six weeks is usually recommended.

When can I exercise again?

Light activities like walking can be resumed almost immediately. We generally advise avoiding strenuous exercise, heavy lifting, and contact sports for four to six weeks to allow the mesh to integrate fully with your tissues.

Can the hernia come back after surgery?

With a mesh repair, the recurrence rate is very low, typically around 1-2%. Following post-operative advice, such as avoiding heavy lifting during the healing period, helps to ensure a durable result.

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Inguinal Hernia Repair Surgery

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An inguinal hernia is a bulge that occurs in the groin region when part of the intestine or fatty tissue pushes through a weak point in the lower abdominal wall. It is the most common type of hernia, accounting for around 75% of all abdominal wall hernias, and is significantly more common in men than women. You may first notice a lump in the groin that appears when you cough or strain and disappears when you lie down.

While a small, reducible inguinal hernia may cause minimal symptoms, they do not resolve on their own and carry a risk of becoming trapped (incarcerated). At Kinvara Private Hospital, we provide rapid access to consultant-led surgical repair to resolve your hernia definitively.

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Surgical repair is the only effective treatment for an inguinal hernia. The procedure involves pushing the protruding tissue back into the abdomen and reinforcing the weakened muscle wall with a synthetic mesh. This mesh acts as a scaffold for new tissue to grow into, creating a strong, long-lasting repair.

We offer both open surgery (the Lichtenstein technique) and keyhole (laparoscopic) surgery (TAPP and TEP techniques). Both approaches are highly effective, with low recurrence rates. Our experienced surgeons will discuss the advantages and disadvantages of each method with you and recommend the best approach for your individual circumstances.

Diagnosis and Pre-Operative Assessment

An inguinal hernia is usually diagnosed through a physical examination. Your surgeon will examine your groin while you are standing and ask you to cough or strain. They will feel for a bulge in the inguinal region and determine whether it can be pushed back into the abdomen (reducible). If the diagnosis is uncertain, or if a hernia is suspected but not palpable, an ultrasound scan can be arranged to visualise the groin.

Once the diagnosis is confirmed, we will discuss the surgical options with you and arrange a pre-operative assessment. This includes a review of your general health, medications, and fitness for anaesthesia. We will provide clear instructions on how to prepare for your surgery, including fasting guidelines.

Understanding Inguinal Hernias

The inguinal canal is a passageway through the lower abdominal wall. In men, it contains the spermatic cord (which holds up the testicle), while in women, it contains a ligament that helps support the uterus. The canal is a natural point of weakness in the abdominal wall. An inguinal hernia occurs when the lining of the abdomen (peritoneum) and abdominal contents push through this weak point.

There are two types of inguinal hernia: Indirect and Direct. An indirect hernia follows the path of the inguinal canal and in men can descend into the scrotum. This type is often related to a congenital weakness that has been present since birth. A direct hernia pushes directly through the back wall of the inguinal canal and is typically caused by weakening of the muscles over time due to age or strain. Both types are repaired using similar surgical techniques.

Benefits of Surgery at Kinvara

Rapid access to an experienced consultant general surgeon
Choice of open or laparoscopic surgical techniques
Day case surgery for most patients
Low recurrence rates with modern mesh repair
Quick return to normal activities

Why Do Inguinal Hernias Develop?

Inguinal hernias result from a combination of muscle weakness and increased abdominal pressure. Some people are born with a weakness in the inguinal canal, while others develop weakness over time due to aging, chronic coughing, heavy lifting, or straining during bowel movements or urination. Activities that repeatedly increase intra-abdominal pressure can force tissue through this vulnerable area.

Risk factors include being male (inguinal hernias are about 8 times more common in men), having a family history of hernias, being overweight, having a chronic cough (e.g., from smoking or lung disease), and having a history of previous inguinal hernia (which increases the risk of a hernia on the other side or a recurrence).

Surgical Repair Techniques

Conservative Management

For patients with a small, minimally symptomatic hernia who are at high surgical risk, a strategy of 'watchful waiting' may be considered. This involves monitoring the hernia for any changes in size or symptoms. However, this approach only delays surgery, as the hernia will not resolve on its own and will likely grow larger over time. It is generally not recommended as a long-term strategy.

Surgical Options

We offer two main surgical approaches:

Open Repair (Lichtenstein Technique): An incision of approximately 6-8cm is made in the groin. The hernia is reduced, and a flat piece of synthetic mesh is placed over the weakened area and sutured in place. This is a highly reliable technique with a very low recurrence rate and is typically performed under local or general anaesthesia as a day case.

Laparoscopic Repair (TAPP or TEP): This is a keyhole approach using three small incisions (each about 1cm). A camera and instruments are used to repair the hernia from behind the muscle wall. Mesh is placed to cover the defect. This approach often results in less post-operative pain and a faster return to normal activities. It is particularly advantageous for repairing bilateral hernias (hernias on both sides) or recurrent hernias.

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