Treatment options for inguinal hernia repair

An inguinal hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the lower abdominal muscles. The resulting bulge can be painful. Over time, this bulge can increase in size, leading to potentially serious complications.

Inguinal hernias generally start as a lump or bulge in the groin region. They can change in size with activity and usually will pop out during strenuous activity or lifting. These hernias usually can be able pushed back in, or reduced, but can require lying down flat to accomplish this.

Inguinal hernias can progress to discomfort, ranging from a dull ache to sharp, stabbing pain.

An inguinal hernia isn't necessarily dangerous, but it most likely will not improve on its own. And it can lead to serious complications requiring emergent surgery. Your health care professional is likely to recommend surgery to fix an inguinal hernia that's painful or enlarging. If your hernia does not cause any symptoms, it is safe to observe and not surgically repair it. Inguinal hernia repair is a common surgical procedure.

If hernias are left untreated with no symptoms, 75% of patients will develop some sort of symptoms in the future.

The two general types of hernia operations are:

Robotic-assisted/laparoscopic repair

Robotic-assisted or laparoscopic repair is a minimally invasive procedure that requires general anesthesia. In this procedure, the surgeon operates through several small incisions in your abdomen. A small tube equipped with a tiny camera, called a laparoscope, is inserted into one incision. Guided by the camera, the surgeon inserts tiny instruments through other incisions to repair the hernia using synthetic mesh.

The main advantages of robotic or laparoscopic hernia repair are lower risk of infection, less postoperative pain, and quicker return to work or normal activities. These advantages are amplified for patients with hernias on both sides of their abdomens or recurrent inguinal hernias.

Robotic-assisted or laparoscopic repair allows the surgeon to avoid scar tissue from an earlier hernia repair, so it might be a good choice for people whose hernias recur after open hernia surgery.

Open hernia repair

In open hernia repair, the surgeon makes an incision in your groin and pushes the protruding tissue back into your abdomen. The surgeon then sews the weakened area, often reinforcing it with a synthetic mesh. Then the opening is closed with stitches, staples or surgical glue.

This procedure is performed under local anesthesia and sedation, or general anesthesia. This is a good option for patients who have a high risk of complications due to general anesthesia.

After surgery, you'll be encouraged to move as soon as possible, but it might be several weeks before you're able to resume normal activities.

Learn more about hernias and surgery:

• What you need to know when preparing for surgery
• Hernia prevention tips

Christopher C. Johnson, M.D., is a general surgeon in Eau Claire and Menomonie, Wisconsin.