During open surgery to repair a femoral hernia, the surgeon makes a single cut (incision) in your lower tummy or over the hernia. This incision is usually about 3 to 4cm long.
The femoral canal (a channel containing the main blood vessels and nerves leading to the thigh) is opened and the surgeon places the lump of fatty tissue or loop of bowel back into your tummy.
The femoral canal is then closed, often with a mesh plug, to repair the weak spot that let the hernia through.
The incision in your skin is then sealed with stitches. These usually dissolve on their own over the course of a few days after the operation.
If the hernia has become trapped (strangulated) and part of the bowel damaged, the affected segment may need to be removed and the ends of healthy bowel rejoined. This is a bigger operation and you may need to stay in hospital for a few days.
Laparoscopic (keyhole) surgery
During keyhole surgery to repair a femoral hernia, several very small incisions are usually made instead of a single, larger incision.
A thin tube containing a light and a camera (laparoscope) is inserted through 1 of the incisions, so the surgeon can see inside your tummy.
Special surgical instruments are inserted through the other incisions, so the surgeon can pull the hernia back into place. As with open surgery, a mesh patch is often used to strengthen the weak spot in the tummy where the hernia came through.
Once the repair is complete, the incisions in your skin are sealed with stitches or surgical glue.
Which technique is best?
The National Institute for Health and Care Excellence (NICE), which assesses medical treatments for the NHS, says that both keyhole and open surgery for hernias are safe and work well.
With keyhole surgery, there's usually less pain after the operation because the cuts are smaller.
However, the risks of serious complications, such as the surgeon accidentally damaging the bowel, can be higher in keyhole surgery.
The risk of your hernia returning is similar for both operations.
Discuss the advantages and disadvantages of keyhole surgery and open surgery with your surgeon before deciding on the most appropriate treatment.
Deciding which technique to use
The choice of technique for femoral hernia repair largely depends on:
- your general health – elderly people or people in bad health may be too weak or frail to safely have a general anaesthetic, so open surgery under local anaesthetic may be advised
- the experience of your surgeon – open surgery is more common than keyhole surgery, so not all surgeons have enough experience in keyhole techniques
Keyhole surgery can be useful if your surgeon isn't sure exactly what type of hernia you have.
NHS waiting times
If your GP refers you to a consultant for specialist treatment, such as surgery, you have the right to start treatment within 18 weeks.
You may be able to book your hospital appointment through the NHS e-Referral Service while you're still in the GP surgery.
Read more about NHS waiting times for treatment.