Femoral Hernia Repair
Also known as: femoral herniorrhaphy or femoral hernioplasty
Femoral hernia repair is a necessary surgical procedure to correct a hernia that appears in the groin.
What is a femoral hernia?
A femoral hernia is a relatively uncommon type of abdominal hernia that occurs when a portion of the bowel or fatty tissue pushes through a weak spot near the femoral canal. This canal is located in the groin area, where the femoral artery and vein pass from the abdomen into the leg. Unlike inguinal hernias, which are more common and occur higher up in the groin, femoral hernias develop lower down, at the site of the femoral canal.
Although femoral hernias account for only a small percentage of all abdominal hernias, they can lead to serious complications if left untreated. They are more prevalent in older women, primarily due to the wider structure of the female pelvis, which makes it easier for the hernia sac to protrude through the abdominal wall.
When diagnosing a femoral hernia, healthcare providers look for a range of symptoms, which may come and go and are often more noticeable when standing or straining. Recognising these signs is key to ensuring timely medical treatment.
Common symptoms include:
- A painful lump in the inner thigh or groin
- A bulge in the upper thigh near the groin, which may flatten when lying down
- If the hernia becomes obstructed, symptoms may escalate to include nausea, vomiting, and abdominal pain.
Prompt medical attention is essential. Early detection and treatment help prevent complications such as strangulation, where the blood supply to the trapped tissue is cut off, potentially leading to tissue death and severe pain.
Causes and risk factors
Women who have given birth multiple times are at a heightened risk because pregnancy can weaken the abdominal wall and increase intra-abdominal pressure. Additionally, you’re more at risk if you:
- Are obese
- Have a persistent, heavy cough
- Engage in sudden physical strain, such as heavy lifting
- Strain during bowel movements
- Have chronic constipation that increases abdominal pressure
While femoral hernias are more frequent in older populations, particularly older women, they can occur in anyone. Awareness of these risk factors helps prevent and detect femoral hernias early, reducing the chances of complications.
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When is femoral hernia repair surgery needed?
Femoral hernias always require surgical repair due to the high risk of serious complications. If left untreated, portions of the intestine or other tissues can become trapped (a condition known as incarceration), which may cut off the blood supply and lead to strangulation—a life-threatening emergency.
If the hernia becomes strangulated or obstructed, emergency surgery is essential to release the trapped tissue and restore blood flow.
Preparing for femoral hernia repair surgery
Before your procedure, you’ll attend a pre-operative consultation with a general surgeon. This appointment allows you to discuss the surgical plan in detail, ask any questions you may have, and receive important pre-surgery instructions. Carefully following these guidelines is essential for a safe procedure and smoother recovery.
In preparation for surgery, you may be advised to quit smoking at least two weeks beforehand. Doing so improves your body’s ability to heal and reduces the risk of complications. You’ll also need to arrange for transportation and post-operative care, as you won’t be able to drive yourself home after the procedure. It’s helpful to inform your employer and family members about your surgery date and expected recovery time so they can support you as needed.
Your surgical team will provide specific dietary instructions, which may include fasting for a period before the procedure. Staying well-hydrated is important, but you should avoid eating or drinking anything late the night before surgery. Additionally, practising deep breathing and leg exercises in the days leading up to your surgery can help enhance circulation and speed up recovery.
Finally, it’s crucial to discuss your current medications with your surgeon. Some medications may need to be adjusted or temporarily stopped to ensure optimal conditions for surgery and minimise potential risks.
During surgery
This straightforward procedure typically lasts between 30-45 minutes and is performed under general anaesthesia, where you are completely asleep.
There are different approaches to the surgery:
- Open surgery: The surgeon makes an incision approximately 3 to 4 cm long to access the femoral canal and reposition the herniated tissue.
- Laparoscopic method: This involves multiple small incisions, allowing the surgeon to repair the hernia with minimal tissue damage. This method often results in quicker recovery times and less postoperative pain.
A mesh plug is often used to reinforce the hernia site, reducing the likelihood of recurrence, regardless of the surgical approach.
After surgery
Immediate post-surgery care
After femoral hernia repair surgery, you will be able to go home the same day, although you may feel dizzy and tired for 24-48 hours due to the effects of general anaesthesia. Regularly taking prescribed pain relief medications is crucial for managing discomfort effectively in the initial days following surgery. Engaging in gentle movements at home enhances blood circulation and lowers the risk of blood clots.
During recovery, you should focus on:
- Following a good diet to avoid constipation
- Proper wound care
- Monitoring for swelling or bruising at the wound site and surrounding tissue wall
A lump may develop under the surgical wound, but it is generally not a cause for alarm. Any concerns about wound infection should be promptly addressed with a healthcare provider.
Long-term recovery
Avoid heavy lifting and strenuous activities for approximately six weeks to facilitate healing. Most patients can gradually resume light activities after 1-2 weeks and typically return to driving within this timeframe, depending on their pain and comfort levels. Make sure to consult with your surgeon about when it is safe to drive again.
Your diet can be resumed normally, but you should avoid alcohol for two days following anaesthesia and refrain from smoking for two weeks post-surgery. A high-fibre diet is recommended to prevent constipation. Avoiding contact sports for at least 12 weeks is advised to prevent strain on the surgical site.
It is recommended that you follow your surgeon’s advice and attend follow-up appointments to ensure proper healing.
Potential complications
As with any surgical procedure, femoral hernia repair carries some risks and potential complications, though it is generally considered low-risk. One of the most serious concerns is strangulation, where the blood supply to the trapped bowel tissue is cut off. If left untreated, the risk of strangulation can reach up to 22% after three months and 45% after 21 months. Other possible complications include infection at the incision site, recurrence of the hernia after surgery, and adverse reactions to anaesthesia, which can occur in some patients.
Older patients or those with preexisting conditions have a higher likelihood of facing complications post-surgery. You should be informed about the signs and symptoms of complications such as incarceration, strangulation, and obstruction, and discuss any concerns with your surgeon.
Appointment and Treatment Plan
Appointment
Based on your previous consultation with a doctor, an appointment will be arranged between you and a consultant general 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
Before 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.
Experts
We are proud to provide patients with access to a wide range of clinicians, chosen specifically for their knowledge and reputation in their area of expertise. Our experts align with our values: putting you at the centre of your care and educating you on your options at each step of the journey. We encourage you to learn more about our clinicians and how they can help you below. As always, please contact our patient services team if you require any additional information.
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FAQs
A femoral hernia is a condition in which fatty tissue or part of the bowel protrudes through a weak area in the abdominal wall in the groin, specifically at the femoral canal where the femoral artery and vein pass. This type of hernia can lead to discomfort and complications, warranting medical attention.
Individuals most at risk for developing a femoral hernia include older women, especially those who have had multiple births, as well as individuals who are obese or suffer from chronic coughs and engage in activities that raise abdominal pressure.
The primary symptoms of a femoral hernia are a painful lump in the inner upper thigh or groin, which may reduce when lying down. If obstruction occurs, it can lead to more severe symptoms such as nausea, vomiting, and abdominal pain.
Surgery is always necessary for a femoral hernia to prevent complications like strangulation and obstruction. Even asymptomatic cases typically require elective repair to mitigate the risk of emergencies.
The recovery process after femoral hernia repair surgery generally involves avoiding heavy lifting and strenuous activities for approximately six weeks. Patients can typically resume light activities within 1-2 weeks, and following dietary recommendations is essential to prevent constipation. Regular follow-up appointments are important to monitor healing.
Medically reviewed by Mr Shashank Gurjar - Consultant Colorectal & General Surgeon on 19/05/2025