Inguinal hernia repair
What is it?
What is it?Types of treatment
Although there are several different techniques to repair an inguinal hernia without using a prosthesis (also called a ‘mesh’). The current guidelines from the European Association for Abdominal Wall Surgery (EHSS) say that an inguinal hernia in an adult is best repaired by placing an abdominal wall prosthesis. The most important reason for this is that fewer patients will have a recurrence of the hernia over time.
Placing a prosthesis to strengthen the abdominal wall in the groin can be done in the traditional way (open surgery with an incision in the groin) or laparoscopically (via keyhole surgery with three small incisions).
At the Maria Middelares Hernia Centre in Ghent, we usually opt for laparoscopic hernia repair surgery or a keyhole surgery. However, sometimes there are good reasons to perform the classical open surgery. The surgeon will discuss this with you during the pre-operative consultation.
For inguinal herniae repair, we have used a self-fixing meshon our department since 2009. This mesh was developed by Dr Philippe Chastan in Bordeaux (ProGrip®). This has small grips similar to a Velcro® system that can bind on to the tissues. As a result, we no longer have to use painful sutures or staples to keep the mesh in place. If you wish, your surgeon can show you the mesh during the pre-operative consultation.
For a laparoscopic, or keyhole, surgery, the surgeon uses a scope with a video camera and special instruments to repair the hernia. This is done by installing a mesh without making a large incision. The mesh is placed laparoscopically right in front of the peritoneum, after first returning the inguinal hernia inwards. At the Maria Middelares Hernia Centre in Ghent, we prefer the laparoscopic technique because of reduced post-operative pain and a quicker recovery.
At the Maria Middelares Hernia Centre in Ghent, we mainly use the ‘Lichtenstein technique' for open repairs. This entails strengthening the groin by placing a mesh through an incision across the groin.
For large inguinal hernias, that are presenting on both sides, the Stoppa technique is sometimes used. A midline incision is made and a large mesh that covers both sides of the groin is placed.
The open inguinal hernia repair techniques constitute a small minority of the total number of inguinal hernias we repair at the Maria Middelares Hernia Centre in Ghent.
Possible complications
Possible complicationsAn inguinal hernia operation is generally a safe procedure. Serious complications are rare. Possible complications are listed below. This is not an exhaustive list, but it contains the most frequent complications:
| Bleeding, wound infection and the development of wounds. | Infection of the prosthesis. |
| Bleeding in the abdominal wall or groin; this sometimes requires another operation. | Accidental injury of the bowel or other abdominal organ, the bladder, for example. |
| Switch from keyhole surgery to an open procedure. | Complications that are not directly caused by the surgery: pneumonia, bladder infection, heart rhythm disorders, etcetera. |
| Complications associated with general or epidural anaesthesia. | Over the long term, the surgical site will remain painful for some patients. |
Side effects
Some side effects occur very frequently but are no reason for concern:
After the operation, a swelling often remains for a few weeks where the umbilical hernia was located. This fluid accumulation (also termed seroma) is not usually painful, but it often causes patients concern. This swelling is a normal side effect of the surgery and will slowly disappear on its own. If, in exceptional cases, the fluid accumulation causes pain, the surgeon may decide to drain it.
Another common side effect is bruising around the wounds. These are no cause for concern either, as they will spontaneously disappear in the weeks following the operation.
In case of doubt or concern, feel free to contact your GP or our department.
Can an inguinal hernia recur?
When a mesh is placed, the chances of a relapse (recurrent) or another incidence on the same side as the inguinal hernia repair is extremely rare. The percentage is approximately 1-3% in the first ten years after the operation.
If you have a inguinal hernia repair on one side, you have approximately 10% chance of developing an inguinal hernia on the other side in the next ten years.
Guidelines for at home
Guidelines for at homeInguinal hernia repairs can be performed in the day clinic for most patients. If necessary, admission for one night will be arranged.
We would like you to be active and move around a lot as soon as possible after the operation.
To be avoided for three weeks:
- lifting heavy loads
- intensive sport practice
After discharge from hospital:
- Visit your GP ten days after the procedure for a check-up of your wounds. For keyhole surgeries, your GP will remove the sutures. Of course, you or your GP can always contact our department in case of any issues.
- A three-week follow-up appointment will be scheduled for you with the surgeon who performed your operation. After these three weeks, you may resume all your activities, including lifting and sports.
How much does a inguinal hernia repair cost?
How much does a inguinal hernia repair cost?The Maria Middelares Hernia Centre in Ghent charges the official rates of the RIZIV. In addition to the surgeon's and anaesthesiologist's fee, this will display the general charges for hospital admission and the use of materials such as the mesh. A supplement to the fees will also be charged if a single room is chosen.
Centres and specialist areas
Centres and specialist areas
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Latest publication date: 13/08/2024
