General laparoscopic surgery
A bulge in the groin that does not go away by itself.
Your surgeon: Stefanos Lazaridis MD, FRCS, Director, 11th Surgical Clinic for Obesity & Reflux, Metropolitan General, Athens · formerly NHS Consultant in Upper GI & Bariatric Surgery, London
Short answer
An inguinal hernia is a weakness in the lower abdominal wall in the groin, through which fat or bowel pushes out as a bulge. It is much more common in men. A hernia does not heal on its own and tends to grow over time. Treatment is surgical repair with a mesh, which I usually perform as a day case by the laparoscopic TEP technique.
Symptoms
Many hernias cause only a small bulge at first. An irreducible, painful hernia is an emergency, because the bowel can become trapped.
Causes
Most inguinal hernias are related to increased pressure in the abdomen together with a weak point in the abdominal wall. Risk factors include chronic cough, constipation, heavy lifting, obesity, pregnancy, smoking and ageing. Some people are born with a weaker abdominal wall.
Treatment
Surgery is the only treatment that fixes a hernia. A truss can hold it in but does not repair it. In most adults the repair is done with a mesh, which reinforces the abdominal wall and lowers the risk of recurrence.
I usually prefer laparoscopic repair (TEP): less pain, small scars and a quicker return to normal activity, and both sides can be repaired through the same small incisions. Read more about TEP repair.
Questions
Not always immediately. A small hernia with no symptoms can sometimes be watched, but most eventually need repair, and planned surgery is safer than emergency surgery.
With modern mesh repair, recurrence is uncommon.
No. With the laparoscopic technique both sides are repaired in the same operation, through the same incisions.
Next step
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