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Groin hernia · Patient guide

The femoral hernia.

A groin hernia that sits lower than the common inguinal one, through a narrow and unforgiving opening. Less common, but more likely to trap bowel — which is why it is usually repaired promptly, and why any new groin lump deserves a look.

A femoral hernia pushes through the femoral canal — a narrow space in the groin, below the inguinal ligament, where the large blood vessels run down to the leg. It produces a bulge in the upper thigh or groin, lower than the more familiar inguinal hernia. It is less common, and occurs more often in women, particularly older women.

What sets it apart is the opening it comes through: narrow, surrounded by firm structures, and slow to forgive. That anatomy is why a femoral hernia is more likely than other groin hernias to trap and squeeze its contents, and why it is generally treated with more urgency.

Signs and symptoms

  • A lump in the upper thigh or groin, sitting lower than a typical groin hernia.
  • Discomfort or aching in the groin, sometimes with little to feel on the surface.
  • In some cases the first sign is the emergency one — sudden pain, a hard tender lump, and vomiting.

When to seek care the same day. A femoral hernia that becomes hard, painful and irreducible, especially with nausea or vomiting, may be strangulated. This is an emergency — go to an emergency department immediately.

When surgery is the right call

Almost always, and without long delay. Unlike some inguinal hernias, a femoral hernia is not generally suited to watchful waiting, because its narrow neck carries a real risk of obstruction and strangulation. Elective repair — planned, on a list, in good conditions — is far safer than an emergency operation on trapped bowel.

The repair

The principle is to reduce the contents and close the femoral canal, reinforcing the area with mesh.

Open repair

Through a small groin incision the hernia is reduced and the canal closed with mesh. This is a sound, well-established approach, particularly when the repair is urgent.

Laparoscopic repair

Keyhole repair places mesh behind the muscle wall, covering the femoral opening from inside, and is a good elective option — particularly where the diagnosis is uncertain or both groin areas need assessing. The same keyhole repair can also be done with a robotic platform where the added dexterity helps.

The choice between them follows the situation: whether the operation is elective or urgent, the anatomy, and your own circumstances.

Recovery

An elective femoral repair is usually day surgery, with recovery much like an inguinal repair: walking straight away, desk work within one to two weeks, and heavier activity by four to six weeks. Recovery after an emergency repair for trapped bowel is longer and depends on what was found.

Risks, honestly

Elective femoral repair is a safe, common operation. The usual risks are bruising, seroma and, uncommonly, recurrence. The more important risk is the one of not repairing it: leaving a femoral hernia carries a meaningful chance of an emergency down the line, which is why prompt repair is advised.

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Common questions

Femoral hernia — answered

Both appear in the groin, but a femoral hernia passes through a narrower opening below the inguinal ligament, near the vessels to the leg. The narrow neck makes it more likely to trap bowel, so it is usually repaired without delay.
Its narrow, rigid opening gives it a relatively high chance of obstructing or strangulating. Repairing it electively is far safer than waiting for an emergency.
They are less common than inguinal hernias and occur more often in women, particularly older women. A new groin lump in a woman should always be assessed with a femoral hernia in mind.
Yes — by open or laparoscopic technique, with mesh to reinforce the area. The approach is chosen from the situation, including whether the repair is elective or urgent.