Finding out you have a hernia on both sides of your groin can leave you wondering if you’ll need two separate operations. Fortunately, surgeons can often repair both hernias in the same procedure, especially if minimally invasive surgery is suitable for you.
Known as bilateral inguinal hernias, these develop when tissue pushes through weakened areas of muscle or tissue on both sides of your groin.
In this article, we explain how bilateral inguinal hernia repair works, when both sides can be treated together and what to expect as you recover.
What is a bilateral inguinal hernia?
An inguinal hernia develops when fatty tissue or part of your bowel pushes through a weakened area of muscle or tissue in your lower abdomen, causing a bulge in your groin.
If this happens on both the left and right sides, you have bilateral inguinal hernias. You may notice a lump or swelling in each groin, although one side can sometimes be more noticeable than the other.
Other symptoms can include:
- Pain or aching in one or both groins
- A feeling of pressure or heaviness
- Discomfort when you cough or lift something
- Swelling that’s easier to see when you stand or strain
Some inguinal hernias cause very few symptoms. If you have discomfort on both sides but only one obvious lump, your surgeon can examine both groins and may recommend further tests if the diagnosis isn’t clear.
Can both inguinal hernias be repaired during one operation?
If you have confirmed inguinal hernias on both sides, it’s often possible to repair them together. Laparoscopic (keyhole) surgery is particularly useful for this, as your surgeon can reach both hernias through the same small incisions in your abdomen.
Treating both sides together can help you avoid a second operation, another general anaesthetic and a separate recovery period.
However, repairing both hernias at once isn’t always the most suitable option. Your surgeon will consider your general health, the size and position of each hernia and any previous abdominal surgery before recommending treatment.
How are bilateral inguinal hernias repaired?
Surgeons can use minimally invasive techniques to repair bilateral inguinal hernias, including laparoscopic and robot-assisted surgery. Both approaches use small incisions to access the affected areas, rather than the larger cuts used in traditional open surgery.
The aim is to return the tissue causing each hernia to its normal position and strengthen the weakened areas to reduce the risk of the hernias returning.
Laparoscopic hernia repair
During laparoscopic hernia surgery, your surgeon makes a small number of incisions in your abdomen and inserts a camera and specialist instruments. The camera provides a clear view of the area, helping your surgeon locate the hernias and repair both sides during the same procedure.
Two techniques are commonly used, known as TAPP (transabdominal preperitoneal) and TEP (totally extraperitoneal). With TAPP, your surgeon enters your abdomen to reach the hernias. With TEP, they work between the muscles and the lining of your abdomen, without entering the abdominal cavity.
Both usually use surgical mesh (a thin, supportive material) to strengthen the weak areas.
Robot-assisted hernia repair
This approach uses similar keyhole techniques but with the support of robotic technology. Your surgeon controls the robotic instruments from a console (a control station in the operating theatre), allowing them to make precise movements while viewing the surgical area in detail.
The robot doesn’t operate independently. Your surgeon remains in complete control throughout the procedure.
Both approaches can be effective, and robot-assisted surgery isn’t necessarily better than conventional laparoscopic repair for every patient. The most suitable technique will depend on your individual needs and your surgeon’s assessment.
Assessing your hernias before surgery
Before undergoing bilateral inguinal hernia repair, you’ll have a consultation to confirm the diagnosis and discuss your treatment options. Your surgeon will examine both groins and ask about any symptoms you’ve experienced, including pain, swelling or discomfort during everyday activities.
They’ll also review several factors that could influence your treatment, including:
- Your general health and medical history
- Any previous hernia or abdominal surgery
- The size and position of each hernia
- Any medicines you’re taking
- Your job and how active you are
If the diagnosis is unclear, your surgeon may recommend an ultrasound scan to examine the affected areas more closely.
Your surgeon will then explain the available treatment options and help you understand if repairing both hernias together is right for you. You’ll also have time to ask questions about the operation and what to expect afterwards.
The bilateral inguinal hernia repair procedure
You’ll usually have a general anaesthetic for bilateral inguinal hernia repair using laparoscopic or robot-assisted techniques, meaning you’ll be asleep throughout the operation.
Your surgeon will make several small cuts in your abdomen and insert specialist instruments to reach the hernias. They’ll gently move the affected tissue back into place before strengthening the weak areas, usually with surgical mesh.
Once both hernias are repaired, your surgeon will remove the instruments and close the cuts.
As with any operation, there are potential risks, including infection, bleeding, long-lasting groin pain or a hernia coming back. Your surgeon will explain these risks and how they apply to you before treatment.
Recovering after bilateral inguinal hernia surgery
How quickly you heal will depend on your overall health and the type of surgery you have. Many people can go home on the same day, although you’ll need some time to rest before getting back to your usual routine.
It’s normal to have some soreness, bruising or swelling around the groin after surgery. You may also experience temporary bloating or shoulder discomfort caused by the gas used during keyhole surgery.
There are several things you can do to support your recovery.
Take time to rest
You may feel tired or uncomfortable during the first few days, so give yourself time to recover. Your surgeon will advise you on pain relief and how to care for your wounds.
Keep moving, but carefully
Although rest is important, light activity can support your healing. Short walks can help your blood flow and lower the risk of blood clots, so start slowly and increase your activity as you feel able.
Avoid heavy lifting
You’ll usually need to hold off on lifting anything heavy or doing strenuous exercise for around four to six weeks. Your surgeon will advise you on when it’s safe to resume these activities, depending on your operation and recovery.
Return to your normal activities gradually
Many people can return to work within one to two weeks, although you may need longer if your job involves physical activity or heavy lifting.
Full recovery from inguinal hernia surgery can take around four to six weeks. Everyone recovers at a different pace, so follow your surgeon’s advice and gradually increase your activity as your discomfort improves.
Discuss bilateral hernia repair with Mr Achal Khanna
Having hernias on both sides of your groin doesn’t always mean two separate operations. Minimally invasive surgery may allow both hernias to be repaired together, depending on your individual circumstances.
Mr Achal Khanna is an experienced private general surgeon in Milton Keynes, specialising in laparoscopic and robot-assisted hernia repair. He’ll carefully assess both hernias and explain your options, helping you make an informed decision about your treatment.
If you’ve been diagnosed with bilateral inguinal hernias or are experiencing symptoms, contact Mr Khanna today to arrange a consultation and discuss the treatment options available to you.