inguinal hernia: Keyhole mesh or open incision mesh method?

I was in exactly your position a few months ago. I read everything and talked to the surgeon, and came to the same lack of conclusion! Eventually I talked with a neighbour who it turned out had had two inguinal hernias, one on each side, at different times, and had one done by keyhole, the other by open surgery. He said he definitely would choose keyhole if he had to have another one, so that's what I went for. He said the recovery time was considerably shorter. Mine (at Heatherwood in Ascot) took a week or so to feel right, but I'm guessing it would have been longer with open surgery. Hope this helps!

Is it possible to repair that hernia without a mesh? I had a horrible time with my mesh and always like to warn people about it...

Because of a previous prostate surgery i did not have the option of keyhole and had open inguinal surgery 6 months ago. I had a very discomforting first week and actually was not very comfortable for a month. Cutting through the muscle brings about a whole set of problems you can avoid with keyhole. I am still felling numbness around the scar. My cancer surgery was keyhole and far less evasive.

As with everything, there are cases which don't work out. Mesh can cause problems, but it seems not to in 99% of cases, which people don't write about. I have not found any serious, reliable sources suggesting there are non-surgical ways to fix a hernia. The whole point is it will never heal by itself. So you can live with it and mitigate the pain as far as possible. Or you can have surgery, which is apparently effective in the vast majority of cases (by either method), and which actually fixes the problem and leaves you able to resume life as before. I am almost 4 months in after surgery, and I never think about it now. I do yoga, I ride my bike fast off-road, I lift my 8-year-old son. Fear of surgery is not, I think, an adequate rationale for saying don't have it.

Where did you get another figure? Any figure you have is guesswork, as is mine. But the NHS does literally hundreds of these operations every day. There are plenty of places where patients could and would register their complaints if this were, as you seem to be suggesting, a frequent issue. It simply doesn't appear to be. I don't believe the NHS would continue using the procedure if it were causing widespread harm and complaint, let alone litigation. Maybe it's different in America. (Well, actually I know it is, having lived there for 30 years and experienced the entirely dysfunctional healthcare system there.) But we don't just sit back and say nothing if something's wrong in the UK. In fact, we're world-class complainers! So I think there is a danger you are inflating a small number of issues, possibly with specific surgeons, into widespread fear-mongering.

I'm afraid your anger and rudeness are misplaced on this forum, and elsewhere for that matter. I did a lot of research into this before having my hernia operation, and the use of mesh is well supported in all the documentation publicly available. My own experience of it backs this up. I am very sorry you had a bad experience with it, but that doesn't permit you to ride roughshod over others' experiences and research. I hope you recover soon, and that you find a better outlet for your anger than this forum.

Thanks for replies. I have learned a lot and decided the NHS will do a good job and I don't think I will need to wait long.

Thanks for replies. I have learned a lot and decided the NHS will do a good job and I don't think I will need to wait long.

My understanding is that there is not much difference in recurrence rates or risks of chronic post-op pain comparing keyhole and open incision for simple groin hernia repairs. Recovery time from keyhole may be (slightly) shorter, but again there's not much in it. The one thing you do want to avoid is keyhole surgery by an inexperienced surgeon: the very small risks of more serious complications are higher in this case.

Another consideration - depending on your circumstances - is whether you want a general or a local anaesthetic. Keyhole can only be done under general anaesthetic. Open incision can be done under either local or general anaesthetic, although the latter is more common.

For what it's worth, I had open incisional surgery under local anaesthetic with a very experienced NHS surgeon. The operation went very well and I have no lasting post-op pain. It's 3 months ago now and I am back to swimming 40 lengths etc.

Thank you, Ulfgar, and I'm very glad you've settled on a path forward, Sally. Please do let us know how you get on. It's always difficult to judge the effectiveness etc. of procedures if all you ever hear about are the times when something went wrong.

(By the way, after the rather acrimonious exchange about mesh, I don't think the NHS offers to repair inguinal hernias in any other way, so your only other option would have been to go private, which is very expensive.)

Best of luck, Sally! Hope this all helped.