While many inguinal hernias can be repaired laparoscopically nowadays, the open approach remains a gold standard operation and a better choice for some patients. Reasons may include hernia size, a hernia that cannot be completely reduced with pressure or lying flat, previous surgery and abdominal contour. The best approach for your hernia will be discussed with you at your consultation.

Open inguinal hernia repair involves approaching the hernia from the front using a small groin incision. The hernial contents (bowel or fat) are returned to the abdominal cavity along with the sac or the sac may be excised. A mesh is secured in place to reinforce the groin region. This is important to give strength to the repair.

Serious complications of inguinal hernia repair are uncommon. Complications include:

• Bleeding
• Difficulty passing urine initially (urinary retention)
• Persistent (chronic) pain that does not go away
• Wound infection
• Mesh infection
• Injury to the blood supply to the testicle
• Bowel injury (if the hernia contains bowel)

All hernias can recur even with a good repair and if you do all the right things after surgery. About 10% of inguinal hernias recur. The risk of recurrence can be reduced by:

• Losing weight if you are overweight
• Avoiding very heavy lifting
• Avoiding straining with bowel or bladder movements (treating constipation and symptomatic prostate enlargement)

Open inguinal hernia repairs can often be performed as a day case although some patients do need to stay overnight. Recovery can be variable. Some patients feel ready to return to normal activities relatively quickly, while others can have persistent soreness for a longer period and take longer to return to normal physical activity. Even if you are feeling great it is important to follow your postoperative instructions, particularly limits to lifting, as the repair needs time to develop strength.