Groin Hernia Treatment

A groin hernia can typically be diagnosed with a simple physical exam, but when patients come in with a bulge in the groin area, pain (in the testicle for males), and burning, they may want to consider surgical treatment.

“Some people will argue that you can watch them if the hernia isn’t causing any symptoms,” Dr. Compton continued. “However, they’ve had studies where people who are in the watch-and-wait category—up to 65-75% of patients—end up having surgery within five years due to new or worsening symptoms. That wait time can lead to strangulations or incarcerations as well as enlargement of the hernia leading to a more complex repair.”

Treatment Options

The two most common types of groin hernia treatments are the open anterior Lichtenstein repair with mesh and laparoscopic; both are outpatient procedures. Lincoln Surgical will work with each patient to determine the pros and cons of laparoscopic and open surgery for their particular situation.

Open Surgery

In the open surgery, most surgeons use an ultra-lightweight polypropylene mesh that is about three to four times the burst pressure of the abdominal wall. There is less mesh contracture and pain with the lightweight meshes. The recovery time for the open approach is about a week. One possible complication of open surgery with mesh is nerve entrapment, which can cause chronic pain.

Laparoscopic Surgery

According to Dr. Compton, TEPP is a laparoscopic approach used by Lincoln Surgical for groin hernia repair. “The TEPP involves getting in the peritoneal plane under the muscular layers and the fascial layers but above the peritoneum; the peritoneum makes up the hernia sac,” Dr. Compton said. “So you dissect that away from the cord structures, then put a mesh underneath the muscles, rather than on top like in the open approach.”

“One nice thing about using the laparoscopic approach on a patient with a recurrence is that you can get into a virgin plane that’s never been operated on, making the reoperation a little easier,” Dr. Compton added. “Another nice thing about laparoscopic surgery is patients who undergo laparoscopic surgery typically have less pain postoperatively and have a quicker return to normal activity. In addition, patients with bilateral inguinal hernias can often have them repaired at the same time.”

“One caveat to laparoscopic surgery is that it’s very difficult to do on heavier or obese patients because of excess visceral fat, making the preperitoneal working space smaller and the dissection more difficult and potentially dangerous,” he said.

The recurrence of hernia after herniorrhaphy is 2-4% regardless of the operative approach, open or laparoscopic.

Improve Your Patients' Discomfort Today

For Dr. Compton, one of the best parts of performing hernia surgery is seeing an immediate improvement to a painful condition. To get your hernia patients back to the golf course or to doing whatever makes them happy, refer them to Lincoln Surgical Associates.