Surgical closure of an inguinal hernia

An inguinal hernia is a weakness in the connective tissue of the abdominal wall at the point where the spermatic cord runs from the abdominal cavity into the scrotum. When the pressure in the abdominal cavity increases, e.g. during pressing or heavy lifting, intestines can push into this gap. In the worst case, the bowel becomes trapped, making emergency surgery necessary. A hernia operation is performed to prevent this

In the embryo, the testis is an abdominal organ that only migrates through the inguinal canal into the scrotum shortly before birth. The spermatic cord passes through this canal to the testicle. The blood supply and vas deferens run through the spermatic cord. The inguinal canal closes generally, but it is still a natural weak point at the lowest part of the abdomen. This can lead to a protrusion of the intestine, known as an inguinal hernia. Women also have an inguinal canal, but it is much narrowed, making inguinal hernias much rarer.

An inguinal hernia can manifest itself in different ways. Unfortunately, the narrow hernias that are difficult to detect without a medical examination are also the most dangerous. These can be very painful. The bowel slips through the small gap and becomes trapped, which can cut off the blood supply and lead to intestinal obstruction requiring emergency surgery. Less acute are the larger inguinal hernias, which often become noticeable through bulges in the area of the groin or scrotum. They can often be pushed back into the abdomen with the fingers.

Yes. However, it eventually becomes noticeable through pain or, at the very latest, when it grows in size.

There is no prospect of spontaneous healing because the hernia is in a weak point of the body. In fact, the opposite is the case. Due to the inevitable recurring pressure by the abdomen, the hernia will become larger over time.

Since the lower abdomen, inguinal canal, and testicles fall under urology, it is recommended that the surgery is performed by an experienced urologist. They are very familiar with the anatomical structures, which minimises the risk of complications such as testicular shrinkage due to blood vessel constriction. However, because a hernia also involves the intestine, the surgery is also performed by a medical specialist in surgery.

Short info on hernia surgeries

Indication Inguinal hernia of any severity
Procedure Open surgery or robot-assisted da Vinci method using the keyhole technique
Surgery time Approx. 1 hour
Clinic stay 1-2 days
Note General anaesthesia recommended

Questions about hernia surgery

Open surgery is performed through an incision in the groin. The abdominal cavity is not opened. The hernia gap is closed with several sutures. Insertion of a mesh is usually not necessary. It is also possible to gain access to the groin by means of laparoscopy. This is possible using the robot-assisted da Vinci method, which allows for a very precise and gentle procedure. Access is gained through the abdominal cavity and the hernia is closed from the inside, so to speak. This requires the insertion of a mesh.

There is no general answer to this question, and it depends on many factors, which are discussed in detail before the procedure. All surgical procedures for the treatment of an inguinal hernia are offered at the Goldstadt Private Clinic.

The advantage of the open technique is that the abdominal cavity does not have to be opened. This avoids complications that can occur after any abdominal surgery, such as intestinal adhesions. In addition, mesh does not have to be used to close the hernia. Like any foreign body, mesh carries the risk of infection, which can make another operation necessary. If urological surgery in the area of the lower abdomen becomes necessary later in life, such as in the event of prostate cancer, this is often made much more difficult by the previous surgery.

A keyhole procedure offers the advantage of small incisions in the abdomen that are usually hardly visible later. In addition, a hernia is less likely to recur. Chronic pain is also less frequent.

Depending on the procedure, an inpatient stay for 1-2 days after the surgery is recommended. It is advised to avoid physical exertion for some time after the operation. A check-up is necessary following the procedure.

Yes, a hernia can sometimes recur, but this does not occur often.

About this page:


Prof. Dr. med. Sven Lahme
Urology specialist

Medical director of the Goldstadt-Privatklinik.
Specialist for Urology, Mini-PCNL and robot-assisted da Vinci procedures.

Member in Scientific Societies and Reviewer of scientific journals.

Creation Date: 08.03.2020Modification date: 08.03.2020