Femoral hernia repair 

Introduction 

Hernia: animation

This animation explains how a hernia occurs and the procedures used to treat it

Media last reviewed: 14/11/2013

Next review due: 14/11/2015

Other types of hernia

For information on other types of hernia see: 

A hernia occurs when an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall.

Your muscles are usually strong and tight enough to keep your intestines and organs in place, but a hernia can develop if there are any weak spots.

What is a femoral hernia?

A femoral hernia is an uncommon type of hernia. It's estimated that only about one in every 20 groin hernias are femoral hernias, and the rest are inguinal hernias.

Femoral hernias sometimes appear as a painful lump in the inner upper part of the thigh or groin. The lump can often be pushed back in or will disappear when you lie down. Coughing or straining may make the lump appear.

What causes a femoral hernia?

A femoral hernia usually occurs when fatty tissue or a part of your bowel, such as the intestine, pokes through into your groin at the top of your inner thigh.

It pushes through a weak spot in the surrounding muscle wall (abdominal wall) into the femoral canal. The femoral canal is a channel through which blood vessels and nerves pass to and from your leg.

Unlike inguinal hernias, femoral hernias occur far more frequently in women, particularly older women. This is because of the wider shape of the female pelvis. Femoral hernias are rare in children.

Femoral hernias can sometimes appear suddenly due to strain on the abdomen, such as straining on the toilet if you have constipation, or carrying and pushing heavy loads. They have also been linked to obesity and having a persistent, heavy cough.

When is surgery needed?

Femoral hernias can be repaired using surgery to push the bulge back into place and strengthen the weakness in the abdominal wall.

Unlike some other types of hernia, treatment of femoral hernias is almost always recommended straight away because there is a higher risk of complications developing in these cases.

Complications that can develop as a result of a femoral hernia include:

  • obstruction – where a section of the bowel becomes stuck in the femoral canal, causing nausea, vomiting and stomach pain, as well as a painful lump in the groin
  • strangulation – where a section of bowel becomes trapped and its blood supply is cut off; this requires emergency surgery within hours to release the trapped tissue and restore its blood supply so it does not die

Surgery will get rid of the hernia and prevent any serious complications, although there is a chance of it returning after the operation.

What happens during surgery?

There are two ways that an femoral hernia repair can be performed:

  • open surgery – where one cut is made to allow the surgeon to push the lump back into the abdomen
  • keyhole (laparoscopic) surgery – a less invasive but more difficult technique where several smaller cuts are made, allowing the surgeon to use various special instruments to repair the hernia

There are advantages and disadvantages to both methods. The type of surgery you have will depend on which method suits you and your surgeon’s experience.

You should be able to go home the same day or the day after surgery. It is important to follow the hospital's instructions on how to look after yourself. This includes eating a good diet to avoid constipation, caring for the wound and not straining yourself too soon.

Most people make a full recovery from femoral hernia repair within six weeks, although many people are able to return to driving, work and light activities within two weeks.

Read more about how femoral hernia repair is performed and recovering from femoral hernia repair.

Are there any risks from the operation?

Femoral hernia repair is a routine operation with very few risks, although around 1% of hernias will return after the operation.

Other uncommon complications of femoral hernia repair include:

  • developing a lump under the wound
  • difficulty passing urine
  • injury or narrowing of the femoral vein (which passes through the femoral canal)
  • injury to the bowel
  • temporary weakness of the leg
  • injury to the nerves, causing pain or numbness in the groin area

Complications are more likely if you are over 50 or you have another illness, such as heart disease or breathing problems.




Page last reviewed: 21/10/2013

Next review due: 21/10/2015

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Comments

The 6 comments posted are personal views. Any information they give has not been checked and may not be accurate.

davide1968 said on 24 August 2014

I had an open hernia repair (right) back in June at King's College Hospital. Was in at 7.30, and out by 16.00. Everything went well. Met part the team before the operation, then the rest of it in theatre. When I woke up from general anaesthesia, was taken back to the ward; where a member of staff was always around. and I felt well looked after. They were al friendly and helpful. First night was not too painful, days 2-5 were much more painful, I kept taking medication given by hospital. Went back to work one week after, but only desk and computer based tasks. For another 2-3 weeks was feeling some degrees of pain and numbness; but situation was gradually improving. 4 weeks later I was virtually symptoms-free. The whole experience was fine, and I have no complaints regarding my care.

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Alea78 said on 26 June 2014

I had a double femoral hernia repair via key hole surgery two weeks ago. I'm 35 years old. BMI is fine, but of course I would have this!!

Pain post op wasn't too bad and in the second week I have been mobile and almost back to normal. Though careful not to lift or push. The latter has proved difficult as i have a toddler whom i need to push in a buggy to school.

So, everything's going well until a few hours ago. I've developed the same dull ache that i had before the op, on my right side, in the femoral area! I'm terrified the op has been unsuccessful. Anyone else been through this?

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Tpm63 said on 25 April 2014

Have just returned from Doctors having found the tell tell sign of a Femoral Hernia. Now waiting for scan to confirm.
This will be my third hernia ,the previous double hernias were repaired successfully using the Mesh method in open surgery ? The difference this time is that the lump feels more muscular and and cannot be pushed back in , nor is it reactive to coughing. Physical symptoms are however familiar , dull ache and a pulling sensation.
In the meantime while waiting for scan appointment ibuprofen to help with any pain . Will report results .

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Femoral said on 27 June 2012

I am having to have a Laparoscopy to find out if I have a femoral hernia. I do not have a lump so my consultant said the only way to tell is to put a camera inside and have a look at the femoral canal. After that operation I will then get a second operation to sort the problem out if they find a rupture.

I was very interested in the helpful advice given after having the operation. I know that pain killers can cause constipation so you cant win.

Femoral hernias are quite rare and generally spread throughout the country so a general surgeon may not have carried out many femoral hernia operations.

I would like to find out how the canal is mended, my surgeon said that stitching would rip so mesh was the chosen method but another surgeon said that he would stitch the canal.

If anyone can give their advice I would appreciate it.

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Female_patient said on 27 August 2011

The advice is definitely to leave it until it becomes more serious or becomes an emergency. I widh I had had that advice. I wish I had had a GP who recognised what a hernia was, it would have saved me weeks of thinking I had cancer.

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Lynmar said on 12 May 2011

Well i had my repair on March 29th, it was straightforward and I was discharged same day once I could walk ok, and use the toilet without problems. It was quite painful afterwards, and painkillers do help a lot in the days following the repair.

The procedure was performed at Wolverhampton's New Cross Hospital Day Unit, the staff were efficient and helpful.

It has been six weeks, and I have hardly any awareness of the scar.

I have one observation to make where i feel improvements could be made, at least in my case.

I do feel that a gentle laxative would help a lot in the first 2 weeks after the operation to avoid straining, especially if you do suffer from constipation, this could be discussed before the operation with medical staff. You may be told eat more fibre/roughage but this often doesnt work! Also advice regarding how to sneeze without putting undue strain on muscles, simply place a pillow or cushion gently pressing over the scar and hold whilst sneezing /coughing.

Simple advice but very useful for patients to know, I wasnt told but did a bit of internet research.

I am glad I went ahead with the repair as there is always a risk with this type of hernia of strangulation happening.

My soreness has gone and I can walk without pain now, so if you decide to have this repair, just arm yourself with all the information you can to make post op as easy and as comfortable as possible.

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