Inguinal Hernia Repair in Johannesburg

What it involves

Repair reinforces the weak area with a fine polypropylene mesh. Dr Marais performs both laparoscopic repairs (TEP and TAPP — done through three small incisions) and open repairs, choosing the approach that best fits your anatomy and lifestyle.

Inguinal hernias are the most common hernia in adults. They form because the inguinal canal — a passage in the lower abdominal wall that carries the spermatic cord in men and the round ligament in women — is a natural weak point. When intra-abdominal pressure rises (lifting, coughing, straining), tissue can push through.

The two laparoscopic approaches used at Johannesburg Surgical Hospital are TEP (totally extraperitoneal) and TAPP (transabdominal preperitoneal). Both place a mesh behind the weakness through small incisions. Laparoscopic repair has the edge for bilateral hernias, recurrent hernias, and patients returning to physical work.

For complex, recurrent, or bilateral inguinal hernias, Dr Marais also offers robotic (da Vinci) repair — wristed instruments and 3D vision that help with delicate dissection and precise mesh placement. See the robotic surgery page for detail on when this approach adds value.

Open repair (the Lichtenstein technique) remains excellent for large or complicated hernias and is done under local or spinal anaesthesia when general anaesthetic carries higher risk.

For overweight and obese patients, laparoscopic (TEP/TAPP) and robotic (da Vinci) inguinal hernia repair are usually preferred over open surgery. Open groin dissection through a deeper fat layer is technically harder and has a higher rate of wound complications; minimally invasive repair places the mesh behind the muscle wall through small ports, which heals more reliably in this group. Robotic wristed instruments help with precise mesh positioning in the preperitoneal space in larger patients.

When it's indicated

If you can feel or see a bulge in the groin — especially one that appears with coughing, lifting, or standing — you should be assessed. Repair is elective unless the hernia becomes painful, hard, or irreducible.

The approach

Most patients go home the same day. Return to desk work is typically within a week; heavier physical work within four to six weeks.

Recovery

Same-day discharge for most patients. Simple painkillers for the first three to five days. Driving after seven days if you can perform an emergency stop without hesitation. Return to desk work at one week; gym and heavy lifting from four to six weeks. The mesh is fully incorporated by three months and the repair is permanent.