A hernia is a protrusion, commonly through a defect in the muscles of the abdominal wall. The defect or weakness
can occur from birth, or due to a strain on that part of the abdominal wall (e.g. heavy lifting or pregnancy) or a tear during strenuous exercise. They can occur
in the groin area (inguinal or femoral hernia) around the umbilical and midline areas or around sites of previous abdominal operations 
(incisional hernia). When they occur in both groins at the same time, they are known as bilateral hernias and when they have come back after an operation, they are known as recurrent hernias.

Many hernias need to be repaired with an operation, because of symptoms of pain and discomfort, or the small risk of strangulation (if the hernia gets stuck and blood flow stops) or obstruction (physical blockage of a piece of bowel trapped in the hernia). Surgery can be in the form of a traditional open operation or by laparoscopic surgery, both usually performed as a day procedure.

Laparoscopic surgery is often referred to as 'keyhole' surgery. Unlike ‘open’ surgery, the hernia is repaired through
small incisions in the abdomen rather than a single incision over the hernia. Very small cuts are made in the abdomen and a fine telescope (a laparoscope) and other specialised instruments are inserted through these cuts. In either approach, a piece of synthetic mesh is usually inserted to reduce the risk of the hernia recurring.

The laparoscopic method may have the advantage of causing less post operative pain and patients may be able to return to full
activity in a shorter time. The risks from each approach are different and your consultant will discuss the pros and cons of each.

Surgery You will usually have a pre-op assessment in the week before surgery where blood tests, chest X-ray and an ECG (heart recording) may be taken. You will be admitted a few hours before the approximate planned time of surgery having had nothing to eat for six hours before the start time (you may drink water up to two hours before your proposed time of surgery - with any of your regular medications). You will see your surgeon and the anaesthetist before your operation. After your surgery you will wake up in the recovery room, and then be transferred back to the ward. Later the same day you may have something to eat and drink if you wish. Most people are discharged home later the same day.

You will be provided with painkillers before discharge but it is recommended that you take regular paracetamol and ibuprofen (unless you are sensitive to these) after a few days of these. Stronger painkillers such as cocodamol may be necessary but if so it is important to take a laxative such as lactulose at the same time. You can expect to have some discomfort for up to 3 weeks after surgery, but it will gradually subside. It may be slightly more uncomfortable for longer if you have had an open procedure but most people are predominantly back to normal by six weeks. With both types of surgery there will still be minor twinges for many months as the tissues around the mesh organize themselves. You will be able to take gentle exercise but should avoid heavy lifting or strenuous work for 4 weeks. You may drive a car when you are able to perform an emergency stop. There are usually no stitches to be removed.

You might have some bruising around your groin which can be extensive and may take several weeks to settle. You may also feel bloated for a few weeks. If the wound swells, becomes more painful and hot, or starts to discharge, you should contact the ward or your General Practitioner. You will be seen for follow-up six weeks following your surgery.

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