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Procedure · Lichtenstein

Open hernia repair.

The durable open mesh repair — a small groin incision, the hernia reduced, a flat mesh laid over the defect. Long established, and the approach that can be done under local or regional anaesthetic when a general one is best avoided.

Open repair fixes a groin hernia through a single small incision over the groin. The hernia is reduced and a flat sheet of mesh is laid over the weak area to reinforce it — the technique usually called the Lichtenstein repair. It is one of the most reliable and best-studied operations in surgery, with a low recurrence rate, and it has one feature keyhole repair does not: it can be done without a general anaesthetic.

It is used mainly for inguinal and femoral hernias, and is often the better choice for a first hernia on one side.

Who it suits

  • A first hernia on one side — a straightforward, durable fix.
  • Patients for whom a general anaesthetic is best avoided, since open repair can be done under local or regional anaesthetic.
  • After certain previous lower-abdominal or pelvic surgery that makes the keyhole approach harder.

For hernias on both sides or recurrent hernias, laparoscopic repair is often preferred — the route is chosen from the hernia and the patient.

How it's done

  • A small incision is made over the groin and the hernia sac identified.
  • The contents are returned to the abdomen and the sac dealt with.
  • A flat mesh is positioned over the defect and secured, reinforcing the muscle wall so the body's healing grows into it.

It can be performed under general, regional (spinal) or local anaesthetic with sedation, chosen to suit you and your health.

Anaesthetic flexibility is the point. Being able to repair a hernia well under local or regional anaesthetic is exactly why open repair remains valuable for older or higher-risk patients.

Recovery

Open repair is usually day surgery. Expect bruising and a sore, tight groin for one to two weeks. Walking is encouraged straight away. Most people return to desk work within one to two weeks and to heavier lifting and sport by four to six weeks — a little longer than after keyhole repair, with an equally durable result.

Risks, honestly

Open groin repair is one of the safest common operations. The main issues are bruising, seroma, and in a small number of patients persistent groin discomfort. Recurrence after mesh repair is in the low single figures. Serious mesh problems are uncommon in the groin. Everything is discussed fully before any decision is made.

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Common questions

Open repair — answered

The standard open mesh repair for a groin hernia. Through a small incision the hernia is reduced and a flat mesh is laid over the defect to reinforce the muscle wall. Reliable and long established.
Often, yes. Open repair can be done under local or regional anaesthetic, which makes it useful when a general anaesthetic is best avoided — for example in some older patients or those with significant heart or lung disease.
For a first hernia on one side, when a general anaesthetic should be avoided, or after previous lower-abdominal surgery that makes the keyhole approach harder. The decision follows the hernia and the patient.
Most people return to desk work within one to two weeks and to heavier work by four to six weeks — slightly longer than keyhole repair, with an equally durable result.