What Is Open Mesh Inguinal Hernia Repair?

Open mesh inguinal hernia repair is a surgical technique that fixes your hernia using a small incision in the groin and reinforcing the weak area with a piece of synthetic mesh (usually made of polypropylene, a type of plastic material). This is called a tension-free repair because the mesh provides support without pulling your own tissues together under tension.

The most common type of open mesh repair is called the Lichtenstein repair, named after the surgeon who perfected it in the 1980s. This technique has become the most frequently performed hernia repair in the United States and many other countries because it is simple, effective, and produces excellent results in the hands of both specialist and general surgeons.

Figure 1. Illustration of a Mesh-Overlay Repair of Direct Inguinal Hernia.

How Does the Surgery Work?

During an open mesh repair:

1. You’ll receive either local anesthesia with sedation (you’re awake but relaxed and numb) or general anesthesia (you’re asleep). Many patients have this surgery under local anesthesia and go home the same day.
2. The surgeon makes one incision in your groin, typically 3–5 inches long.
3. The hernia sac is identified and the bulging tissue is pushed back into place.
4. The surgeon examines the groin area to identify all weak spots.
5. A flat piece of lightweight mesh (usually about 6 inches by 4 inches) is placed over the weakened area to reinforce it.
6. The mesh is secured in place, typically with sutures (stitches), though some newer meshes are self-gripping or can be attached with surgical glue.
7. The incision is closed with stitches.

The procedure typically takes 30–60 minutes for a single hernia.

What Are the Benefits of Mesh Repair?

Open mesh repair offers several important advantages compared to non-mesh (tissue-only) repairs.

Lower Recurrence Rates:

Mesh repair reduces the risk of hernia recurrence by 50–75% compared to non-mesh repairs. Studies show that mesh repairs have a recurrence rate of only 1–3%. This means that for every 46 patients who have mesh repair instead of non-mesh repair, one hernia recurrence is prevented.

Faster Recovery:

• Shorter hospital stay: Most patients go home the same day or within 1 day.
• Quicker return to normal activities: Patients return to daily activities about 3 days sooner with mesh repair compared to non-mesh repair.
• Earlier return to work: Many patients return to work within 1–2 weeks.

Fewer Serious Complications:

Mesh repairs have fewer nerve and blood vessel injuries during surgery compared to non-mesh repairs.

Less Postoperative Pain:

Studies show that mesh repairs may result in less chronic (long-lasting) pain compared to non-mesh repairs, though this varies between studies.

Proven Track Record:

The Lichtenstein mesh repair has been performed successfully on hundreds of thousands of patients worldwide over the past 40 years, with consistently excellent results.

What Should I Expect for Recovery?

Day of Surgery:

• Most patients are discharged home within a few hours if local anesthesia was used, or the same day or next day if general anesthesia was used.
• You can usually eat a regular diet right away.

First Few Days:

• About 74% of patients are either pain-free or have only minimal discomfort within 24 hours after surgery.[5]
• You may have some soreness, swelling, and bruising in the groin area—this is normal.
• Most patients can walk and perform light daily activities within 1–3 days.

First Few Weeks:

• By 4 weeks after surgery, 97% of patients are either pain-free or have minimal discomfort.
• Return to work: 1–2 weeks for desk work; 2–4 weeks for physical labor.
• Most patients return to normal activities within 10–14 days.

Returning to Full Activity:

• Strenuous exercise and heavy lifting are typically restricted for 2–4 weeks.
• Your surgeon will give you specific instructions based on your individual situation.