Inguinal hernia repair: an OR 101 guide
Reviewed by Rodnie Oro, cath lab charge nurse · Last reviewed: October 2026 · Education only, not medical advice
Inguinal hernia repair in one minute
What it is: surgery to push a groin hernia back and strengthen the weak area, usually with a mesh.
Who it is for: people with a painful or growing groin hernia, or one that has become stuck.
Main risks: bruising, wound infection, the hernia coming back, long-term groin pain.
Usually: under general, regional or local anaesthetic, about 1 hour, home the same day.
On this page: What is inguinal hernia repair? · Who is it for? · When is it done? · Step by step · Recovery · Risks · Kit list · First time in theatre? · FAQ
What is inguinal hernia repair?
An inguinal hernia is a bulge in the groin where fat or bowel pushes through a weak spot in the muscle wall. It is much more common in men.
There are two main ways to repair it:
- Open repair: a cut in the groin; the hernia is pushed back and a mesh is placed over the weak area
- Keyhole (laparoscopic) repair: small cuts in the abdomen; the mesh is placed from inside, useful for hernias on both sides or that have come back
A hernia that becomes stuck and painful (incarcerated or strangulated) needs urgent surgery.
New to the acronyms? See the Cath Lab Abbreviations A–Z.
Who is it for?
It may be considered for people with:
- a groin hernia causing pain or discomfort
- a hernia that is getting bigger
- a stuck (incarcerated) or strangulated hernia, as an emergency
The decision is made by your surgical team, who will talk through the reasons, the alternatives and the risks with you.
When is it done?
Most operations are planned; some are urgent. Before it, you usually have:
- an examination and often a scan
- blood tests and, for bigger operations, an ECG
- a review of your medicines, especially blood thinners and diabetes medicines, as per centre protocol
- fasting instructions
- a chance to ask questions and give consent
Step by step
1. Getting ready
Team brief and WHO checklist first. The anaesthetic team and ODP give the anaesthetic (general, regional or local, as per centre protocol); antibiotics and blood-clot prevention are given as per centre protocol. The circulating practitioner checks positioning, pressure areas, the diathermy plate and warming. The scrub practitioner sets up the instrument trolley and does the first count. For keyhole repair the laparoscopic stack is also checked.
2. Access
For open repair, a cut is made over the groin crease. For keyhole repair, ports are placed at the belly button and either side, sizes per device and operator.
3. Repairing the hernia
- A. Hernia found. The hernia sac is found and separated from the cord or surrounding tissue.
- B. Pushed back. The contents are pushed back inside the abdomen.
- C. Mesh placed. A mesh is placed over the weak area, size per device and operator, and fixed with sutures, tacks or glue, per surgeon.
- D. Closure. The layers are closed and local anaesthetic is injected.
4. Finishing
The wound is closed in layers and skin closed with sutures or glue. Final counts are confirmed before closure, specimens labelled and checked, and the patient goes to recovery with a full handover.
Recovery and aftercare
- First hours: in recovery, then a ward or day unit; pain relief and anti-sickness medicine as needed.
- Going home: usually the same day.
- Activity: walking early; avoid heavy lifting for 2–6 weeks, per surgeon; ask your team.
- Driving: when you can do an emergency stop comfortably; check your insurance.
- Wounds: keep them clean and dry as advised; sutures or clips may need removing.
- Follow-up: clinic review or a phone call, as per centre protocol.
Call 999 if you have severe pain, heavy bleeding, breathlessness or collapse. Contact your team or GP if you have a fever, worsening tummy pain or swelling, vomiting, or a wound that becomes red, hot or leaky.
Risks and complications
Your team will explain the risks that apply to you. Possible problems include:
- bruising and swelling in the groin or scrotum
- wound infection
- the hernia coming back
- long-term groin pain (uncommon)
- difficulty passing urine for a short time
- injury to the cord, testicle blood supply or bowel (rare)
- mesh infection (rare)
Theatre kit list (printable)
Example kit list
Every theatre has its own protocol, and sizes and doses vary.
- general or hernia instrument set
- self-retaining retractor
- mesh, size and type per device and operator
- sutures, tacks or glue for fixation, per surgeon
- laparoscopic stack and ports for keyhole repair
- local anaesthetic, as per centre protocol
- closure sutures and dressings
Procedural steps
- Team brief, WHO sign in; side marked; anaesthesia
- Supine position; prep and drape; count
- Incision or ports
- Sac found; contents reduced
- Mesh placed and fixed
- Closure; local anaesthetic; counts; sign out and handover
First time in theatre?
đź’ˇ First-time tip
- Know your role. Scrub, circulating, anaesthetic and ODP each have their own checks; ask at the team brief.
- Counts matter. Swabs, needles and instruments are counted before, during and at closure; speak up if one is missing.
- Correct side. Check the side marking at sign in and before the cut.
- Mesh check. Read back the mesh type and size before opening, and log it.
- Warmth. Keep warming devices running.
FAQ
Is mesh always used?
Usually, for adults. Your surgeon will discuss the options.
Can I have it under local anaesthetic?
Open repair often can be. Your team will advise.
Will it come back?
A small number of hernias come back after repair.
Related guides
Sources
All checked on 14 October 2026. Each page's own date is shown where it gives one.
- NHS. Inguinal hernia repair. nhs.uk/conditions/inguinal-hernia-repair
- HerniaSurge Group. International guidelines for groin hernia management. Hernia 2018;22(1):1–165. PubMed 29330835
- StatPearls (NCBI Bookshelf), search: inguinal hernia repair. ncbi.nlm.nih.gov/books
- World Health Organization. Surgical Safety Checklist. who.int
Disclaimer
Education only. This page is for general education for healthcare students, theatre staff and curious readers. It isn't medical advice and doesn't replace advice from your own doctor, surgical team or local unit protocols. Equipment and medicines are described generically. No product or manufacturer is recommended. If you think someone is having a medical emergency, call 999.
Disclosure: I work in the medical device industry. This page is independent education and isn't sponsored or reviewed by any company.
All diagrams on this page are original illustrations created for rodnieoro.com.
