Inguinal Hernia

What is a Hernia?

Hernias, in general, occur when an organ or tissue squeezes through a weak spot in the surrounding muscle or connective tissue. While they can develop in various areas of the body, inguinal hernias are particularly prevalent, comprising a significant portion of hernia cases. Read more about hernia surgery here.

Hernia Surgery Sydney Surgery inguinal femoral direct indirect

What is an Inguinal Hernia?

An inguinal hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles. It commonly manifests as a bulge in the groin area and can cause discomfort or pain, particularly when coughing, bending over, or lifting heavy objects.

Causes of an Inguinal Hernia

Inguinal hernias often develop due to a combination of factors, including weak abdominal muscles, aging, strenuous physical activity, chronic coughing, and conditions that increase abdominal pressure, such as obesity or pregnancy.

Why is Surgical Repair Required?

Surgical repair is typically recommended for inguinal hernias to prevent complications such as bowel obstruction or strangulation, where the blood supply to the herniated tissue is compromised. Without intervention, these complications can lead to severe pain and tissue damage, requiring emergency surgery.

What are the options for Inguinal Hernia repair Surgery?

There are two primary approaches to inguinal hernia repair: open surgical repair and laparoscopic repair.

  • Open Repair: Involves making an incision near the hernia site to manually push the protruding tissue back into place and reinforce the weakened abdominal wall with sutures or mesh.
  • Laparoscopic Repair: Utilises small incisions through which a thin tube with a camera and surgical instruments is inserted. This minimally invasive approach offers advantages such as reduced postoperative pain, shorter recovery times, and decreased risk of complications like infection. This is referred to as Laparoscopic Transabdominal Extrapreperitoneal (TEP) Repair and has become the gold standard for hernia surgery.

Laparoscopic Hernia Repair

Laparoscopic hernia repair is a minimally invasive surgical technique commonly used for the treatment of inguinal hernias. This approach involves accessing the hernia site through the abdominal cavity, specifically the preperitoneal space, without entering the peritoneal cavity where the abdominal organs are located.
Dr. Golani specializes in this type of repair, which is known to provide the best surgical outcomes and post-operative results for patients.

Procedure Overview:

During a Laparoscopic Hernia repair, the surgeon makes several small incisions in the abdominal wall, typically near the navel. A specialised camera, called a laparoscope, is inserted through one of the incisions to provide visualisation of the surgical area. Carbon dioxide gas is then used to inflate the abdominal cavity, creating space to work.

Key Steps of Laparoscopic Hernia Repair

  1. Creation of Preperitoneal Space: Dr Golani will carefully dissect through the abdominal wall layers until reaching the preperitoneal space, located between the peritoneum (the membrane lining the abdominal cavity) and the abdominal muscles.
  2. Open Repair: Involves making an incision near the hernia site to manually push the protruding tissue back into place and reinforce the weakened abdominal wall with sutures or mesh.
  3. Hernia Reduction: Once the preperitoneal space is accessed, the herniated tissue is gently pushed back into its proper position within the abdominal cavity.
  4. Mesh Placement: A synthetic mesh patch is then positioned over the weakened area of the abdominal wall to provide additional support and prevent hernia recurrence.
  5. Closure: After ensuring proper mesh placement, the surgical incisions are closed with dissolvable sutures.

Advantages of Laparoscopic Hernia Repair

  • Minimally Invasive: Laparoscopic Hernia repair is performed using small incisions, resulting in less tissue trauma, reduced postoperative pain, and faster recovery compared to traditional open surgery.
  • Lower Recurrence Rates: The use of mesh reinforcement in Laparoscopic Hernia repair helps to strengthen the weakened abdominal wall, lowering the risk of hernia recurrence.
  • Preservation of Peritoneal Integrity: Since the peritoneal cavity is not entered during Laparoscopic Hernia repair, there is a decreased risk of complications such as bowel injury or adhesions. These complications can particularly arise with other methods of repair like Open or Robotic Hernia repair.

Candidates for Laparoscopic Hernia Repair

Laparoscopic Hernia repair is suitable for most patients with inguinal hernias, including those with recurrent or bilateral hernias. However, candidacy for this procedure may vary based on individual health factors. Dr Golani will discuss the options with you in your consultation to determine the most appropriate treatment plan.

Recovery After Laparoscopic Repair

Patients typically experience a quicker recovery following Laparoscopic Hernia repair compared to traditional open surgery. Following hernia surgery, patients are advised to:

  • Most people are fit to resume sedentary occupations after 7 days. If your job involves more physical demands, you need two weeks completely off work followed by two weeks of light duty.
  • Use over-the-counter pain relief medications as needed for discomfort.
  • Refrain from driving for at least five days post-surgery to ensure optimal recovery.
  • Avoid lifting weights exceeding 8kg for the first four weeks, gradually increasing to 15kg over the subsequent four weeks to prevent strain on the surgical site.

Important Points to Remember:

  • No driving for 5 days post-discharge from hospital
  • Your dressings are waterproof so you can shower as normal.
  • Do not sit/soak in a bath for 7 days.
  • Leave your dressings in place for 7 days and can be removed by the yourself
  • Bruising and intermittent pain may continue for a few days
  • Lifting weights may cause complications in your hernia repair. Limit lifting anything heavier than 8kgs for 4 weeks post-surgery. Additionally, you should not lift anything heavier than 15kgs for a further 4 weeks post-surgery
  • Use regular fibre supplement such a Metamucil will help avoid constipation
  • Walking unrestricted is allowed post discharge
  • Cycling/running/swimming is allowed 2 weeks post discharge
  • No special diet post-surgery is required to be followed.
  • Make an appointment to see Dr Golani 4 weeks post-surgery.

Improved Quality of Life

Laparoscopic Hernia repair offers an effective and minimally invasive approach to inguinal hernia repair, with favourable outcomes and reduced recovery times for eligible patients. Numerous studies, including this study (, have demonstrated the success of laparoscopic techniques in inguinal hernia repair. Patients often experience significant improvements in their quality-of-life post-surgery, including reduced pain, enhanced mobility, and increased overall well-being.

Frequently Asked Questions about Hernia Surgery

What If a Hernia Is Left Untreated?

It is important to note that a hernia will not improve without surgery. If a hernia is left untreated, it can lead to serious complications. Here are some potential consequences: