Inguinal hernia repair reduces the protruding contents and reinforces the abdominal wall with mesh. It is performed open, laparoscopically or robotically, with an individualised choice of technique. Recovery is rapid and the recurrence rate is low.
What is the operation?
It is the repair of an inguinal (groin) hernia: returning the contents (usually fat or bowel) to the abdomen and reinforcing the weakened groin wall. In the vast majority of adults a synthetic mesh is used, creating a durable, tension-free repair.
A hernia does not resolve or "heal" with trusses; the definitive solution is surgical. The aim is a repair with the lowest possible recurrence and chronic pain.
When is it needed?
It is indicated for a symptomatic inguinal hernia (pain, bulge, discomfort) and any hernia at risk of complication. Strangulation (an irreducible, painful hernia with risk of bowel necrosis) is an emergency.
Watchful waiting may be discussed for minimally symptomatic hernias, but most eventually need repair as they enlarge. Bilateral or recurrent hernias favour a laparoscopic/robotic approach.
Preparation
Diagnosis is mainly clinical; ultrasound or CT are used in unclear cases. Technique and anaesthesia are chosen according to the hernia and the patient.
Smoking cessation, glycaemic control and treating factors that raise intra-abdominal pressure (chronic cough, constipation, prostatism) are advised to lower recurrence.
How it's done
There are two established, equally acceptable routes. In the open (Lichtenstein) repair the mesh is placed in front of the wall through a small groin incision. In the laparoscopic/robotic (TEP/TAPP) repair the mesh is placed behind the wall (preperitoneal) through small incisions.
The shared goal is tension-free coverage of the whole myopectineal orifice, with careful protection of the regional nerves and the spermatic cord to minimise chronic pain. The minimally invasive approach is particularly advantageous for bilateral and recurrent hernias.
Open (Lichtenstein)
A small groin incision and a tension-free mesh — a reliable, well-proven technique.
Laparoscopic (TEP/TAPP)
Repair through small incisions, with less post-operative pain and faster return — ideal for bilateral/recurrent hernias.
Robotic
A robotically assisted approach with added precision in selected, complex cases.
Recovery
Repair is usually a day case. Walking is encouraged immediately; light activity returns within a few days.
Lifting and vigorous exercise resume gradually over 2–4 weeks (faster after laparoscopic repair). Mild swelling or bruising in the area is common and settles.
Risks & outcomes
A low-risk operation with very good long-term results. Possible complications: seroma, haematoma, infection and, less often, chronic groin pain or recurrence — both minimised by correct technique and nerve protection.
With mesh, recurrence rates are now low. "Success" means a durable, pain-free repair and return to activities.
Frequently asked questions
Is mesh always needed?
In the vast majority of adults, yes: tension-free mesh significantly reduces the risk of recurrence. The material and technique are individualised.
Open or laparoscopic?
Both are valid. The laparoscopic/robotic approach often has advantages for bilateral or recurrent hernias and for faster return; the choice is made together with the patient.
When can I return to exercise and lifting?
Light activity returns within a few days. Lifting and strenuous exercise usually within 2–4 weeks, with individualised guidance.
Can it recur?
With modern techniques the recurrence rate is low. Correct technique and a gradual return to activity minimise it.