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Laparoscopic Inguinal Hernia

Repair

What is an inguinal hernia?
An inguinal hernia is the most common type of hernia and causes either discomfort or a lump in the groin.

How does a hernia occur?
A hernia is a bulge or protusion of the contents of the abdomen (eg intestines) through a weakness in the muscle of the abdominal wall leading to a bulge or lump. Hernias can occur as a result of a weakness in the muscle wall from birth or through gradual weakening of the muscles.

What symptoms do inguinal hernias cause?
Inguinal hernias can cause a variety of symptoms from mild discomfort or a dragging sensation to a large swelling in the groin that can extend into the scrotum in men. Hernias can sometimes cause complications and acute pain as a result of bowel within the hernia becoming trapped, occasionally the bowel may loose its blood supply and this piece of bowel may need to be removed at emergency surgery.

What does the operation involve?
Inguinal hernias can be repaired at open operation or using laparoscopic (keyhole) surgery techniques. A laparoscopic inguinal hernia repair is a keyhole operation performed under a general anaesthetic. Keyhole surgery is associated with less post operative pain, scarring and far faster return to work and exercise than open surgery.

The procedure usually takes about 30 minutes. Whilst you are asleep a small port is put into the abdomen just below the umbilicus through which a telescope will be inserted and gas (carbon dioxide) pumped. Two further small tubes are inserted through which the surgeon puts the instruments.

The surgeon will reduce the hernia and return it to the abdomen and the abdominal wall will be reinforced with a piece of synthetic mesh. The ports will be removed and the wounds closed with glue.

What are the options?
Surgery is the only reliable way to treat inguinal hernias. We know that without treatment hernias will gradually get bigger over time. Hernias also have a risk of causing complications that require emergency surgery and a larger operation.

What are the benefits of surgery?
The aim of surgery is that the hernia should be repaired and that you should be free of pain and able to return to normal activity and exercise. You will also be free of the risk of complications. Keyhole surgery is associated with less post operative pain, scarring and faster return to work than open surgery

What are the risks?
Laparoscopic inguinal hernia repair is a safe and frequently performed procedure. Postoperative bruising is common, however significant complications are rare but include injury to bowel, blood vessels and less than 1 in 100 chance of injury to the blood supply to the testicle. Chronic groin pain following laparoscopic inguinal hernia repair is rare and less than with the open hernia repair. There is a small chance of wound infection. Men occasionally experince difficulty passing urine post operatively and occasionally need a catheter (tube) in the bladder for a day or two.

The chance of the hernia recurring after surgery is approximately 1%, which is equivalent to open surgery. This may require a further operation

Recovery
Most patients can have a laparoscopic inguinal hernia as a day case procedure although occasionally people may prefer to stay one night.

You will be able to return to work within 7 days and gradual return to exercise and full activity with 2-3 weeks.

Summary
An inguinal hernia is a common problem and a laparoscopic inguinal hernia repair is a safe and frequently performed procedure that should allow you to return to work quickly, allow you to be free from pain and the risk of hernia complications.

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