A femoral hernia occurs when muscles in the abdominal wall become weak and tissue from the small intestine, protrudes or bulges out. According to the American College of Surgeons, femoral hernias can develop in males but are more common in women. The main symptom of a femoral hernia is a bulge or swelling in the groin. Some people may also have pain at the hernia site. Risk factors for developing a femoral hernia include obesity, pregnancy and continually straining from constipation or coughing. Femoral hernias need to be repaired through a surgical procedure to prevent serious complications.
Why Is Hernia Surgery Needed?
Once a femoral hernia develops, it almost always requires surgery. In some people, pain may be present, which can become worse overtime as the hernia becomes larger. Even if pain is not present, surgery will still be advised. A potential life threatening complication can develop in people with a femoral hernia. The tissue of the intestines, which is bulging out, may become trapped and strangulated. When the tissue strangulates, the blood supply to the intestinal tissue is cut off, and the tissue can die.
Femoral Hernia Surgery Techniques
There are two types of femoral hernia surgery which may be performed. The type of surgery recommended may depend on the patient’s age, body size and underlying medical conditions. The two types include:
- Open surgery: During open femoral hernia surgery, a large incision will be made in the groin area. The bulging tissue will be located and pushed back into place in the abdominal cavity. If excess tissue is a problem, it may be removed. Sutures will be placed to close the incision.
- Keyhole surgery: Keyhole surgery, also known as laparoscopic surgery, is the other option to repair a femoral hernia. During this procedure, a few small cuts are made to allow the laparoscope to be inserted into the groin. The rest of the hernia repair is the same as during the open procedure.
The laparoscopic hernia repair is usually the procedure of choice for most people. As with other types of laparoscopic surgery, the incisions are smaller than traditional surgery. Smaller incisions often results in less scarring and bleeding. There is also less of a chance of an infection developing with laparoscopic femoral hernia repair. Because the cuts are smaller, most people also have less pain after a keyhole hernia repair and recover faster than with open surgery.
Risks And Complications
According to Cedars Sinai, femoral hernia surgery is a very common procedure. Although the procedure is considered routine, patients should be made aware of all potential risks and complications. Being aware of complications allows a patient to identify problems sooner and seek medical attention before complications become serious. Some possible risks and complications include:
- Anesthesia complications: As with all types of surgery, general anesthesia can cause respiratory complications, increased heart rate and changes to blood pressure. Complications from general anesthesia during femoral hernia repair are uncommon.
- Infection: Any surgical procedure, which involves an incision being made, can possibly result in an infection. The risk of infection with femoral hernia repair is low. Having laparoscopic hernia repair also reduces the risk.
- Blood vessel or organ damage: Although it is very uncommon, occasionally damage to the blood vessels in the legs can occur. Damage to the bowel or bladder and in females, the reproductive organs may also occur in rare instances.
- Leg weakness: If the nerves going to the legs were damaged during the procedure, leg weakness can develop.
- Hernia returns: In most cases, femoral hernia repair is successful. According to the University of Maryland Medical Center, reoccurrence only occurs in about three percent of people who have the surgery.
Although recovery time may vary, most people can resume normal activities in about two weeks when a laparoscopic hernia repair was performed. Recovery time may increase to about a month when open surgery was done. Activity should be slowly increased and heavy lifting and strenuous sports should be avoided for a few weeks after surgery.
Stitches or steri-strips will be used to close the incisions. There may be some drainage from the incisions site for a few days. In some cases, special instructions may be given to care for the incision site. Although some pain is likely, it tends to be less when laparoscopic hernia repair was done. Prescription pain medication may be recommended for the first few days after the surgery.
Patients should watch for signs of complications, such as fever, vomiting, increased pain, redness and bleeding at the incision site. Patients who experience signs of complications after femoral hernia repair should contact their doctor immediately.
Most people have an uncomplicated femoral hernia repair, and the condition does not return. Maintaining a healthy weight helps reduce the chances of a femoral hernia from returning. In addition, activities which put excess pressure on the abdominal wall, such as straining during bowel movements and improper lifting techniques, should also be avoided to prevent future femoral hernias from developing.