Inguinal Hernia Repair
Also known as: herniorrhaphy or hernioplasty
Inguinal hernias, or groin hernias, are the most frequent type of hernia, appearing as swelling in the groin or an enlarged scrotum.
What is an inguinal hernia?
Inguinal hernias, or groin hernias, are the most frequent type of hernia, appearing as swelling in the groin or an enlarged scrotum. They happen when a part of the intestine or fatty tissue protrudes through a weak spot in the abdominal wall into the inguinal canal. Inguinal hernias can be painful and impact daily activities and quality of life.
Inguinal hernias are classified into two main types: direct and indirect inguinal hernia. Direct inguinal hernias emerge through the back wall of the inguinal canal, while indirect ones push through the inguinal ring (the opening of the canal). Both types usually appear as bulges in the groin and can cause discomfort or pain, especially when bending, coughing, or lifting. Recognising these differences aids in accurate diagnosis and treatment.
Hernias occur when weak spots in muscles or tissue allow internal parts of the body to push through. This weakness can be congenital, present from birth.
Inguinal hernias are a common condition that can significantly impact your daily life. Recognising the symptoms, understanding the causes, and knowing the treatment options are crucial steps in managing this condition effectively. Early diagnosis and timely surgical intervention can prevent serious complications and improve quality of life.
Proper post-surgery care and adherence to recovery guidelines are essential for a successful outcome. By staying informed and proactive, you can navigate the challenges of inguinal hernias with confidence and ease.
Causes and Risk Factors
Inguinal hernias can arise from increased abdominal pressure or pre-existing weak spots in the abdominal wall. Direct inguinal hernias result from a weakened posterior wall of the inguinal canal, often due to aging, heavy lifting, or straining. Activities like straining on the toilet or carrying heavy loads can also lead to an inguinal hernia.
Several factors contribute to the development of inguinal hernias. Men are at a significantly higher risk, being eight times more likely than women to develop this condition. Aging weakens abdominal wall muscles, and a family history of inguinal hernias increases the likelihood of experiencing this condition. Other notable risk factors include pregnancy, persistent heavy cough, and physical strain.
Hospital fee guide price: £2,226
Procedure price subject to bespoke quotation
*Additional consultant fee not included
Before surgery
Diagnosing an inguinal hernia typically begins with a physical examination, where your consultant gastroenterologist checks for bulges in your groin. You may be asked to cough or strain while standing to make the hernia more noticeable. This straightforward approach is often sufficient for diagnosis.
If a hernia is not easily detectable during the physical exam, your doctor may use imaging tests such as abdominal ultrasounds or CT scans. Early detection is crucial to prevent complications like obstruction or strangulation, which includes severe pain, nausea, and changes in the colour of the bulge. Accurate diagnosis enables timely and appropriate medical treatments.
Surgery is recommended if your hernia causes discomfort, major complications, or ongoing symptoms. Complications can include tissue becoming trapped, pinched, or cut off from blood supply, particularly in cases involving an incarcerated hernia or strangulated hernia. In such scenarios, prompt surgical intervention is necessary to prevent further health deterioration. Depending on the severity and specific circumstances, the type of surgery—open or keyhole—or emergency surgery will be chosen to repair your hernia. Delaying surgery can lead to more serious complications, so addressing the issue proactively is important. The choice between open and laparoscopic surgery often depends on the patient’s general health. Both methods aim to repair the hernia and prevent recurrence.
Preparing for Surgery
To ensure your safety and minimise risks, you must be medically optimised before undergoing surgery. Your preoperative evaluations may include blood tests, a chest X-ray, and an EKG, depending on your age and health status. Stopping smoking, losing weight and getting fit will all help surgical success and air your recovery. The hospital will provide you with detailed instructions about when to stop eating and drinking before your operation.
During surgery
Inguinal hernia repair surgery typically lasts between 30 to 45 minutes.
Open Surgery
Open inguinal hernia surgery is done under general anaesthesia. The procedure involves making a 6 to 8 cm incision to access the hernia. The Lichtenstein tension-free hernioplasty is a commonly employed technique, where a mesh is placed in the abdominal wall during the repair to provide support. This approach is often chosen for its effectiveness in preventing recurrence.
Keyhole (Laparoscopic) Surgery
Keyhole surgery for inguinal hernia repair is a minimally invasive method involving small incisions instead of a large opening. During laparoscopic surgery, general anaesthesia is used, and a laparoscope is employed for visualisation. The small incisions made during keyhole surgery are typically sealed with stitches or surgical glue after the keyhole inguinal hernia repair is completed. This method is often preferred for its quicker recovery time and reduced post-operative pain.
After surgery
Patients can typically resume normal activities gradually as soon as pain allows, generally light activities after 1-2 weeks. It’s important to avoid heavy lifting and strenuous activities post-surgery to reduce the risk of recurrence. Maintaining a healthy lifestyle, including a proper diet and exercise, supports overall recovery and enhances surgical outcomes.
Immediate Aftercare
After surgery, you can expect soreness and discomfort in your groin. You will receive personalised aftercare advice focusing on wound care and signs of infection. Pain management advice will be provided to help you manage normal post-surgical discomfort, which may include techniques like applying gentle pressure on your wound.
You should avoid lifting heavy objects and refrain from strenuous activity for 4 to 6 weeks to ensure proper healing. Arrange for someone to drive you home after surgery and avoid alcohol and machinery for at least 48 hours following general anaesthesia.
Long-term Recovery Tips
Patients can gradually resume normal activities as pain subsides, typically starting light activities within 1-2 weeks. You should be able to return to work or light activities within 2 weeks. It may take longer to return to driving after open surgery compared to laparoscopic surgery. Consult with healthcare providers regarding the safe timing for resuming driving.
You will need to schedule a follow-up appointment with your consultant to monitor recovery, address concerns, and ensure the success of the hernia repair. Sexual activity is usually fine after hernia surgery when comfortable.
Potential Complications
Hernias can recur with a risk ranging from 3% to 5% after inguinal hernia surgery. Surgery can prevent serious complications associated with inguinal hernias.
Appointment and Treatment Plan
Appointment
Based on your previous consultation with a doctor, an appointment will be arranged between you and your surgeon.
Treatment plan
During this appointment, you’ll go through your medical history, the surgery, the recovery, and together, you’ll decide whether this is a viable option for you.
Pre-op assessment
If surgery is an option, then the surgeon and their team will thoroughly assess whether you’re right for the surgery. They’ll consider your current health, any previous issues, and other external matters.
Surgery
Prior to going through the surgery, our team will ensure that you’re prepped once again. If everything is confirmed, you’ll undergo the surgery and then we’ll explain the aftercare instructions.
Aftercare
If necessary, you’ll stay in a ward for a few hours to ensure that you’re ready to go home after the surgery. However, this may depend on the surgery outcome and whether you need moderate or light assistance.
Follow-Up
You’ll come in a few weeks later and we’ll give you one final check-over to ensure that you’re on track for recovery.
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Many of our treatments have a pay monthly option that allows you to spread the cost of your treatment over 12 months with no credit checks required.
A minimum spend of £300 does apply. We’ll take your first payment upfront and then arrange a direct debit for your monthly payments thereafter. It’s that simple.
Pay using PMI
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Please bring along your policy details including your scheme details, membership or policy number, expiry date and confirmation of eligibility to claim (i.e. your authorisation number). If you do not have these details with you, we will require payment from you on the day. Patients are liable for any amounts not settled by their insurer.
Hospital fee guide price: £2,226
Procedure price subject to bespoke quotation
*Additional consultant fee not included
FAQs
Recovery from inguinal hernia repair is generally straightforward, with comprehensive support ensuring a smooth healing process. Most patients experience a gradual return to normal activities as they heal.
Following the procedure, personalised aftercare advice is provided, emphasising wound care, identification of infection signs, and discomfort management. This guidance is crucial for ensuring a smooth recovery process.
The recovery period after inguinal hernia repair generally allows most patients to return to normal activities within a few weeks, though it can vary depending on individual circumstances and the surgery’s extent.
The purpose of follow-up visits after hernia surgery is to monitor recovery, address any concerns, and ensure the success of the hernia repair. These appointments are crucial for a satisfactory healing process.
Discomfort is expected after hernia surgery, and effective pain management strategies are typically provided to aid in recovery. These may include prescribed medications and recommendations for rest and activity levels.
Medically reviewed by Mr Alastair Windsor - OSD Healthcare Medical Director and Consultant Colorectal & General Surgeon on 21/11/2024