The primary difference in treatment is between mesh and non-mesh (tissue) repair. Mesh repair is the modern, evidence-based standard. A synthetic mesh is used to patch and reinforce the weakened area, acting like a supportive scaffold. This method provides a much stronger repair, leading to a very low recurrence rate of 1-2%. Non-mesh repairs, such as the Shouldice technique, involve stitching the tissue layers together. While it avoids a permanent implant, it places more tension on the tissue and has a significantly higher recurrence rate of 5-15%.
While mesh repair is highly successful, long-term complications can occur, though they are uncommon. The most discussed issue is chronic groin pain (affecting 5-10% of patients), which is often linked to nerve irritation during surgery. Other rare risks include mesh infection, shrinkage, or adhesion to other tissues. It is crucial to weigh these potential risks against the well-documented and higher risk of hernia recurrence without mesh.
In terms of recovery, many patients report a relatively straightforward process, especially with laparoscopic (keyhole) mesh surgery. Common experiences include: being able to go home the same day, managing pain with over-the-counter medication for a few days, returning to desk work within a week, and avoiding heavy lifting for 4-6 weeks. Most emphasise that following the surgeon's advice on activity restrictions is key to a smooth recovery.
For a second opinion, it is essential to consult a Consultant General Surgeon who specialises in hernia repair. Look for a surgeon who performs a high volume of these operations annually. You can ask your GP for a referral to a specialist centre or seek out surgeons at renowned private hospital groups such as Nuffield Health, Spire Healthcare, or HCA Healthcare UK. Many of the top specialists are affiliated with major NHS teaching hospitals, which often have dedicated hernia clinics.