What is Groin Repair?
Groin repair is defined as the surgical restoration or repair of damaged groin muscles.
Groin muscles can be damaged by a groin strain or injury caused by application of too much stress on the groin or thigh muscles due to repetitive motion. It most commonly occurs in athletes who play football, rugby, soccer, hockey and running.
A groin hernia occurs when the intestine bulges through an opening in the muscle wall of the groin area. There are 2 types of groin hernia: inguinal hernia and femoral hernia. An inguinal hernia occurs as a bulge in the groin or scrotum, whereas femoral hernia occurs as a bulge in the groin, upper thigh or labia.
The groin is the part of your hip located between your abdomen and thigh. The groin region has 5 muscles that work in tandem to move your leg. The soft tissues most frequently affected in a groin strain are the oblique muscles in the lower abdomen. Particularly vulnerable are the tendons that join the oblique muscles to the pubic bone. Most often, the tendons that join the thigh muscles to the pubic bone (adductors) are also torn or pulled during a groin injury.
Indications for Groin Repair
Some of the common indications for groin repair include:
- Osteitis pubis
- Sportsmen's groin, also called sports hernia and Gilmore groin
- Adductor strain (groin strain or pull)
- Snapping hip syndrome
- Overuse stress fractures
- Inguinal hernia
Preparation for Groin Repair
Preoperative preparation for groin repair surgery includes:
- Medical evaluation, blood work, and imaging are done.
- You should shower with an antibiotic soap the night or morning prior to the operation.
- You should not consume any solids or liquids at least 8 hours prior to the operation.
- You should avoid supplements or medications such as blood thinners, aspirin, NSAIDs, or vitamin E for several days prior to the surgery.
- Refrain from smoking to decrease the chances of the hernia recurring.
- Arrange for someone to drive you home as you will not be able to drive yourself post surgery.
- A written consent will be obtained from you after the surgery has been explained in detail.
Procedure for Groin Repair
Groin repair can be performed by a traditional open surgery with one long incision, or by a minimally invasive laparoscopic procedure with multiple small keyhole incisions. Your surgeon will determine the best approach based on the severity of the hernia or ruptured tissues in the groin.
In open surgery:
- Your surgeon makes one long incision near the groin area.
- The hernia is located and separated from the tissues around it.
- The hernia sac is either removed or gently pushed back into the belly.
- The weakened abdominal wall muscles are closed with stitches.
- A piece of mesh may also be sewn into place to strengthen the abdominal wall.
- The groin incision is closed and sutured.
In a laparoscopic procedure:
- Your surgeon makes 3 to 5 small keyhole incisions in the lower abdomen.
- A medical device called a laparoscope, a flexible fiber-optic tube with a high-intensity camera and light attached at the end, is inserted through one of the incisions to visualize the inside of the abdomen.
- A harmless gas is pumped into the abdomen through one of the incisions to provide the surgeon more space to work and better visibility.
- Miniature surgical instruments are passed through the other incisions to repair the hernia.
- The same repair process involved in open surgery is carried out.
- Once the repair is completed, the scope and other tools are removed, and the keyhole incisions are closed with stitches.
Postoperative Care and Instructions of Groin Repair
The general postoperative care and instructions involve:
- You will be transferred to the recovery area to be monitored until you are awake from the anesthesia.
- Your nurse will monitor your blood oxygen level and other vital signs as you recover.
- You should get up and walk every hour or two to prevent blood clot formation.
- You can expect pain and soreness in the groin area. Pain medications will be prescribed for comfort.
- You may experience bloating and discomfort in the stomach due to the gas used during surgery. Anti-nausea medications will be prescribed as needed.
- Instructions on surgical site care, driving, and bathing will be provided.
- You should consume high-fiber foods to prevent constipation.
- Refrain from smoking as it can negatively affect the healing process.
- Refrain from any strenuous activities and do not lift any weight heavier than 10 pounds for at least 6 months. You should gradually increase your activity level with light activities.
- You may return to normal activities in 2 to 3 weeks but consult your doctor before returning to any sports activities.
- Strictly adhere to scheduled follow-up appointments to monitor your progress.
Risks and Complications of Groin Repair
Some of the risks and complications of groin repair surgery include:
- Chronic pain
- Wound infection
- Urinary tract infection
- Blood clot or venous thrombosis
- Recurrence of hernia
- Neuralgia or nerve pain
- Seroma or collection of clear yellow fluid
- Hematoma or collection of blood in the wound site