Repairing groin hernias
The principle of repairing all abdominal wall hernias involves the placement of ‘mesh’, which is usually made of plastic. The mesh provides a durable reinforcement of the hernia defect and causes far less pain than previous non mesh repairs. The ‘mesh‘ repair has led to a drastic reduction in the recurrence rates of groin hernia repairs and is relatively easy to perform. Most such operations are performed as a day case with the patient arriving and leaving on the same day. The incision is only 5-7cms in length and hence causes minimal cosmetic disruption. The meshes used in the groin have become thinner and more lightweight with improving technology in an effort to reduce the amount of foreign material implanted whilst not compromising on strength.
Approximately 5-10% of men have hernias in both groins either on the first presentation or on subsequent follow up (so called bilateral hernias). These may be repaired at the same time or on separate occasions, but if done together usually require an overnight stay unless done performing ‘key hole’ surgery (see below).
In some circumstances the operation is performed under ‘local’ anaesthetic and sedation. Here the surgeon injects a drug into the groin which renders the area ‘numb’ often in conjunction with a mild sedative which relaxes the patient and is administered via a vein in the arm. This local anaesthetic technique avoids the effects of having a general anaesthetic and is particularly useful in the elderly and unfit. After the operation the patient is encouraged to walk immediately after the effects of the anaesthetic have worn off and normal exercise is resumed within 2 weeks. The wound is closed with ‘dissolving stitches’ and simply needs to be kept dry for 5 days post operatively.
