Inguinal Hernia

What is an inguinal hernia?

A hernia occurs when some adipose tissue or part of an organ protrudes abnormally through a small or large hole in the abdominal wall. An inguinal hernia is named for its location and is often called a groin hernia. This protrusion occurs in the groin area when part of the intestine or a piece of fat presses through a weak spot in the inguinal canal. An inguinal hernia can become a serious problem so should not be ignored. A surgical consultation and examination should be scheduled if symptoms such as groin pain when lifting or coughing occur.

Causes of an Inguinal Hernia

An inguinal hernia may result from:

  • Strenuous activity
  • Pregnancy
  • A preexisting weak spot in the inguinal canal
  • Chronic sneezing or coughing
  • Increased abdominal pressure
  • Straining during urination or bowel movement

Doctors do not always find an exact reason for the development of an inguinal hernia. Often, the weakness in the abdominal wall at the inguinal canal is present at birth and the result of improper closure of the abdominal lining. This lining can also weaken with age.

Will my hernia heal without surgery?

Hernias do not heal spontaneously. However, experiencing the symptoms of a hernia does not mean that you need surgery right away. If you are not bothered by your hernia, you may be able to postpone surgery. Some people never need surgery for an inguinal hernia. This step is taken if the hernia worsens or is causing significant pain that inhibits the performance of normal activities.

Watch Dr. Jacob Perform a full laparoscopic (TEP) inguinal hernia repair On YouTube

What to expect from Inguinal Hernia Repair Surgery

Dr. Brian Jacob is a nationally and internationally recognized hernia expert who has performed thousands of hernia repair procedures with exceptional outcomes.

Laparoscopic inguinal hernia repair can take up to two hours. The procedure is performed with general anesthesia and the following steps:

  • Constant monitoring while under anesthesia.
  • Three small incisions below the belly button, in the inguinal region.
  • Inflation of the abdomen with carbon dioxide
  • Insertion of a camera and small instruments through incisions.
  • Observation of the inguinal area on a monitor and repositioning of the protruding tissue.
  • Evaluation of the area for other weak spots.
  • If necessary, repair of an incarcerated or strangulated hernia.
  • Closure of incisions.
  • A short time is spent in the recovery room while the anesthesia wears off.

Watch the steps of a standard laparoscopic TEP (total extraperitoneal) inguinal hernia repair:

1.) incision (three small cuts in the midline below the belly button)

Watch This Video On YouTube

2.) creation of TEP (total extraperitoneal) working space

Watch This Video On YouTube

and dissection to reduce the hernia contents:

Watch This Video On YouTube

3.) reduction of hernia (femoral, direct, indirect)

4.) mesh insertion (there are many types of mesh used)

Watch This Video On YouTube


I approached Dr. Jacob to consult whether repair of my inguinal hernia with absorbable mesh was a viable option. It was not; he opined that a lap surgery with a regular mesh would be the best choice for my big hernia, assuming I can take a gen. anesthesia. Earlier I was considering traveling across the country to have a Desarda repair, but Dr. Jacob’s confidence, competence, and support made me trust his expertise and I am glad I did. The surgery was scheduled about three weeks later; his staff was very helpful. No pain pills were needed (not even one); the next day I easily walked four miles along the beach, and three days before the week was over I found myself running intervals for about 25 min. each (I don’t remember Dr. Jacob making any restriction on running). I am grateful to be a patient of Dr. Jacob."

- Vlad

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Most hernia repair procedures are performed on an outpatient basis. Patients go home as soon as their vital signs have stabilized and they are beginning to regain alertness. After your procedure, you can expect some soreness. This typically lasts 24 to 48 hours. The day following your surgery, you need to be up and about as is comfortable. Over a week to 10 days, you can begin to resume normal activities, including showering, walking, climbing stairs, driving, working, and sexual intercourse. A follow-up visit is scheduled approximately 2 weeks after the procedure.

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How long after inguinal hernia repair can I start exercising again?

After laparoscopic inguinal hernia repair, you may begin exercise 1 to 2 weeks after surgery. Dr Jacob will discuss your specific return to exercise regimen after the surgery depending on the findings.

How dangerous is an inguinal hernia?

An inguinal hernia may never cause complications. It is important to be aware of worsening pain or other symptoms. These could indicate the development of:

An incarcerated hernia. The contents of a hernia may get trapped within the weak point of the abdominal wall. This can lead to bowel obstruction, which causes symptoms such as severe pain, vomiting, and the inability to pass gas or have a bowel movement.

A strangulated hernia. An incarcerated hernia can obstruct blood flow to part of the intestine. This is referred to as a strangulated hernia. Without sufficient circulation, the affected tissue could die. This complication requires immediate medical attention.

Pressure on surrounding tissues from the inguinal hernia can lead to increased pain and swelling.

Can inguinal hernias recur after surgery?

According to studies, the recurrence rates range from 2% to 10%.

It is just a hernia…

It is never “just a hernia”.Where and how you have your inguinal hernia repair done can make a tremendous difference in your recovery and in your outcomes.Today, there are many hernia surgeons, like Dr. Jacob, who are experts and now specialize in hernia repairs, so it is important to choose a hernia surgeon that has tremendous experience with proven great short and long term outcomes.

What happens if I don’t treat an inguinal hernia?

Some incidentally discovered hernias can be safely watched for a period of time. Once the intestine or other tissue protrudes through the abdominal wall, however, it won’t improve on its own. That doesn’t mean you’ll have lots of pain. Some people live with a hernia for years without ever knowing they have one. Others live with slight pain when making certain movements, but don’t want to go ahead with surgery. This is probably a mistake, only because the pain is likely causing you to miss out on activities or sports you could want to partake in.

But there are times when leaving a hernia untreated can be a life-threatening decision. If a portion of your intestine becomes trapped in the abdominal wall, this can obstruct your bowel. This will cause severe pain, nausea, and constipation. If the trapped section of intestine has its blood flow cut off, strangulation occurs, and the intestinal tissue can become infected or die. This is a life-threatening condition.

What are some non-surgical treatments for inguinal hernias?

If your hernia is small and isn’t bothering you, Dr. Jacob and your general physician may take a wait and see approach. If the hernia only bothers you with certain movements, wearing a supportive truss can provide the support in those instances. For younger patients, the protruding area can be pushed inward in hopes that it may stay in place as young tissues heal or strengthen.

To take pressure off a minor hernia, you could lose weight. Eating more fiber and whole grains can help prevent constipation and the straining involved with bowel movements. You can avoid lifting heavy objects. If you smoke, stopping can allow you to avoid the chronic cough that creates stress in the hernia area.

What foods can exacerbate an inguinal hernia?

Inguinal hernias can be aggravated by bloating and constipation. Bloating pushes out your abdominal wall and this leads to pain with a hernia in that area. Constipation leads to straining,

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If you would like more information regarding inguinal hernia repair, call our NYC office at 212-879-6677.

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