Groin hernia: keyhole or open repair?

The short answer

Both repair the gap and usually use a mesh. Keyhole uses several small cuts and a camera; open uses one small cut in the groin.

	Keyhole (laparoscopic)	Open
How it is done	Several small cuts in the abdomen, a camera and instruments, and a mesh placed behind the abdominal wall.	One small cut in the groin; the tissue is returned to the abdomen and the weak area reinforced with sutures and/or mesh.
Anaesthesia	General anaesthesia is required.	Spinal or general anaesthesia.
Operation time	60–90 minutes	45–90 minutes
Hospital stay	Walking is encouraged early; most go home soon.	Same day or one night.
Back to daily life	Walking within 1–2 days; driving 3–5 days; office work 1 week.	Walking within hours; driving 3–5 days; light office duty after 1 week.
Heavy lifting	About 90 days (3 months).	About 90 days (3 months).
Hernia coming back	2–5%, lower than open surgery.	5–10%, depending on risk factors and technique.
Bruise or fluid collection	3–6%; usually settles on its own.	Bruise 2–8%, fluid 3–6%; settle on their own.
Wound infection	Under 1%	1–3%
Nerve irritation or pain	1–2%, usually temporary. Chronic groin discomfort 1–2%.	Nerve injury (numbness or pain) 2–6%; usually temporary.
Rare testicle problems	Swelling or pain, under 1%; usually settles.	Reduced blood supply or shrinking, under 1%.

Keyhole (laparoscopic)

How it is done: Several small cuts in the abdomen, a camera and instruments, and a mesh placed behind the abdominal wall.
Anaesthesia: General anaesthesia is required.
Operation time: 60–90 minutes
Hospital stay: Walking is encouraged early; most go home soon.
Back to daily life: Walking within 1–2 days; driving 3–5 days; office work 1 week.
Heavy lifting: About 90 days (3 months).
Hernia coming back: 2–5%, lower than open surgery.
Bruise or fluid collection: 3–6%; usually settles on its own.
Wound infection: Under 1%
Nerve irritation or pain: 1–2%, usually temporary. Chronic groin discomfort 1–2%.
Rare testicle problems: Swelling or pain, under 1%; usually settles.

Open

How it is done: One small cut in the groin; the tissue is returned to the abdomen and the weak area reinforced with sutures and/or mesh.
Anaesthesia: Spinal or general anaesthesia.
Operation time: 45–90 minutes
Hospital stay: Same day or one night.
Back to daily life: Walking within hours; driving 3–5 days; light office duty after 1 week.
Heavy lifting: About 90 days (3 months).
Hernia coming back: 5–10%, depending on risk factors and technique.
Bruise or fluid collection: Bruise 2–8%, fluid 3–6%; settle on their own.
Wound infection: 1–3%
Nerve irritation or pain: Nerve injury (numbness or pain) 2–6%; usually temporary.
Rare testicle problems: Reduced blood supply or shrinking, under 1%.

How the choice is made

Your surgeon chooses with you, based on the size and type of the hernia, whether it is on one or both sides, whether you have had surgery before, and your health and anaesthetic risk.

The figures come from our two separate guides, not from one trial comparing the two operations, so treat the gaps as a guide only.

This page gives general information and does not replace the advice of your treating team. Figures are approximate.