What does surgery involve?
Broadly speaking, there are two ways that a groin hernia can be fixed.
Mesh in the inguinal canal – the ‘tails’ of the mesh surround the tubes to the testicle on that side
This can be carried out under local or general anaesthetic. Your surgeon will discuss this with you. It’s called ‘open’ because a small incision is made in the skin (usually 2.5 – 3 inch), in the groin area. The open approach can be carried out using either general or local anaesthetic, and this will be dependent on both your current health condition and preference after discussion with your surgeon.
At operation the hernia is identified and the hole is either stitched closed (not at all common now) or (much more commonly) a mesh is placed over the hole and fixed using fine stitches. The mesh acts like a scaffold and your own tissue will grow through the mesh to reinforce the weakened area without putting tension on the surrounding tissues.
‘Keyhole’ or ‘laparoscopic’ surgery
Your operation will be carried out under general anaesthetic. One small cut (1-2cm long) near the bellybutton and two small cuts are made in the lower abdomen. Carbon dioxide gas is used to inflate your abdomen and a small telescopic camera is then inserted to view the hernia from within the abdomen. This means that the surgeon is looking at the hole from the inside of the abdomen. A mesh is then place over the hole. It is a bit like repairing a puncture in a tyre with a patch from the inside.
There are in fact two laparoscopic methods:
In TAPP (Trans-Abdominal Pre-Peritoneal) the telescope is placed into the abdominal cavity
In TEP (Totally extra-peritoneal) the abdominal cavity is not entered and the operation takes place placed in the space between the muscles and the lining of the abdomen.
There are advantages and disadvantages to both. In expert hands both methods give equally good results, and you should be guided by your surgeon.
All of the operations usually take between 30 minutes and 90 minutes operating time.