Hernia Repair - Femoral

About the Procedure

Femoral Hernia Repair (Herniorrhaphy; Hernioplasty) is a surgical procedure to resolve a herniated area in the lower abdomen near the upper thigh. It may be performed laparoscopically or with a traditional surgical incision. Femoral hernias occur in the femoral canal in which the femoral artery sits. Women, especially those who have had children, are more likely to have this kind of hernia due to their wider pelvic structure, but it is not a common ailment. The hernia can be caused by rapid, awkward movements, lifting heavy objects, coughing, abnormal stretching or straining, or constipation. Pain is frequently a symptom of a femoral hernia and immediate medical attention is required.

The procedure to repair a femoral hernia is performed by a general or colorectal surgeon in either a hospital or out-patient facility. It can be done under general, regional, or local anesthesia. The surgeon makes three or four small cuts in the lower abdomen and inserts a laparoscope (a telescopic video camera) and instruments for cutting and gripping. The surgeon watches a video monitor as he/she performs the procedure which involves removing the bulging tissue back through the weakened space in the canal and then repairing the hole. In a technique referred to as "tension-free", a mesh graft is placed on either or both sides of the hole to fortify it. When the procedure is complete, the abdominal incisions are closed.

What to Know Before the Procedure

There is a higher incidence of infection when the wire mesh is used, especially in patients with immune system disorders. The graft is foreign material with a risk of rejection which, should it occur, would require a second surgery. Other risks include long-term pain, damage to nearby blood vessels, and damage to or near the reproductive organs in women.

Preparation for this procedure is similar to other operations. A health assessment, blood work, x-rays, adding or changing medications to avoid excess blood loss during the operation, and pre-operative restrictions on food and water intake will be provided by the doctor. Advanced planning for a ride at discharge and assistance at for the first day is recommended because pain and tiredness are the chief complaints at that time.

What to Know After the Procedure

Femoral hernia repairs are often done in an out-patient facility, with the patient being discharged the same day after a period of observation. Some procedures, such as the traditional incision method, typically require an in-patient stay of two or more days with discharge dependent on the patient's progress. Low level physical activity/exercise may be resumed immediately, moderate activity within a week, and return to pre-surgery activity at about 14 days following the laparoscopic procedure. Some tenderness around the surgical site and discomfort when activities involve pressure on the abdomen, e.g., moving from lying to a seated position and from sitting to standing, lifting, sneezing, coughing, etc. are to be expected. The more invasive surgical method requires a much longer recovery and an extended period of restricted physical activity.

If you Need to Travel Outside of your Local Hospital

The rates of recurrence of hernias are lowest when surgeons have considerable experience with laparoscopic surgery. Choosing a surgeon with excellent technical skills and experience helps to avoid complications and should be a major factor in determining where the procedure will be performed. Due to a quick recovery period, with most patients being back to moderate activity within a week, long-distance travel for this procedure is not prohibitive. This provides a wide range of doctors, locations, and price points to be explored for treatment of this condition. Speak with several doctors about pre and post-operative care, and when discussing the possibility of international travel, also speak with the doctor about recommended recovery times and travel plans.