Advice on what to do before hernia surgery

[keengkong]

I need advice on what to do before hernia surgery. I was doing squats last nights and I started feeling pain in my lower abdomen on the right side slightly above and slightly to the right of my penis. It was concerning enough that I stopped working out. I then felt the area and looked at it. I realized I had tissue there that was not on the other side. I immediately suspected that it was either cancer or I had suffered my first hernia. When I checked the internet and saw the locations for them, what I saw fit perfectly with an inguinal hernia. After a largely sleep night -- due to anxiety not pain -- I went to the urgent care today. The doctor felt the area and said she didn't feel any intestines. I then asked why that area is bigger than the other side. She said that's likely swelling. She said she believes it's likely that I have a hernia but that the tissue went back inside. She said it's possible, although unlikely, that it will never happen again. However, she was she was referring me to a surgeon for a consultation to discuss surgery to repair the area. I asked about whether I can work out now. She said to work out like I did before. Before I left, I asked how long it would take to hear from the surgeon's office. The person said it would take two to three weeks. Would you feel comfortable working under the circumstances if you were in a similar situation? By the way, my inclination during the surgical consultation would be to attempt to confirm that what I have really is a hernia. Other than that, if I have an inguinal hernia, I'd want it repaired because I don't want to have to avoid tons of exercises due to a fear of harming myself. Thanks for the help anyone is able to give me.

 

[bob357sig]

My 2 cents on this is; if a doctor looked at it, and wasn’t overly concerned and told you to carry on, I would do exactly that! I personally would just be extra aware of that area and maby just not push it too crazy, at least till you get that second opinion from the other doctor. Again, this is just what I would do personally. Good luck with this issue though. Bob.

 

[deadbeef]

I worked out for many months with an inguinal hernia. Just don't do things that aggravate it.

 

[keepbashing]

An inguinal hernia cannot be treated conservatively, except by avoiding strain. However, it does not get smaller and will not close on its own.

Clinical examination, ultrasound, and, if in doubt, MRI are the options for diagnosis. A CT scan can be omitted.

If you are young and want to continue strength training, you won’t be able to avoid surgery IF it's an inguinal hernia.

Depending on your age, I would recommend a Lichtenstein operation, or if you are young and plan to support healing with HGH and GLOW, a Shouldice operation. Personally, I prefer to operate on young, athletic patients with good connective tissue using the Shouldice technique, as it results in fewer long-term issues such as irritation or loss of sensation. However, the success of this surgical technique is extremely dependent on the surgeon. Only a truly experienced surgeon who has performed a large number of Shouldice operations will be able to achieve a good outcome.

 

[keengkong]

Thanks for your expert answer. It sounds like I'll be getting a Lichtenstein operation.

 

[keengkong]

My 2 cents on this is; if a doctor looked at it, and wasn’t overly concerned and told you to carry on, I would do exactly that! I personally would just be extra aware of that area and maby just not push it too crazy, at least till you get that second opinion from the other doctor. Again, this is just what I would do personally. Good luck with this issue though. Bob.

I'm inclined to do as you and the doctor recommend. And if it hurts, I'll stop and I won't do anything that hurts.

 

[keepbashing]

View attachment 358414
Thanks for your expert answer. It sounds like I'll be getting a Lichtenstein operation.

Get a proper diagnostic workup. If a hernia is confirmed and you wish to continue weight training, I recommend having it repaired sooner rather than later. At the age of 56 on a fit individual with your goals, a Lichtenstein repair or TEP would be my preferred option.

Whether to choose an open Lichtenstein procedure or a minimally invasive TEP (totally extraperitoneal) repair should, in this case, depend on the experience of the surgeon. In my opinion, a surgical robot is unnecessary. A laparoscopic TEP repair provides excellent results, as does the Lichtenstein technique.

The use of a da Vinci system, compared to standard laparoscopic TEP surgery, offers no real advantage here. On the contrary, operating with the da Vinci system requires significant experience and, in my opinion, may be disadvantageous due to the longer operating time.

Inform yourself about both the Lichtenstein and TEP techniques and make your decision based on the expertise of the surgeon. Have the procedure performed in a certified hernia surgery center with a high procedural volume and proven experience.

 

[crispybacon!]

I need advice on what to do before hernia surgery. I was doing squats last nights and I started feeling pain in my lower abdomen on the right side slightly above and slightly to the right of my penis. It was concerning enough that I stopped working out. I then felt the area and looked at it. I realized I had tissue there that was not on the other side. I immediately suspected that it was either cancer or I had suffered my first hernia. When I checked the internet and saw the locations for them, what I saw fit perfectly with an inguinal hernia. After a largely sleep night -- due to anxiety not pain -- I went to the urgent care today. The doctor felt the area and said she didn't feel any intestines. I then asked why that area is bigger than the other side. She said that's likely swelling. She said she believes it's likely that I have a hernia but that the tissue went back inside. She said it's possible, although unlikely, that it will never happen again. However, she was she was referring me to a surgeon for a consultation to discuss surgery to repair the area. I asked about whether I can work out now. She said to work out like I did before. Before I left, I asked how long it would take to hear from the surgeon's office. The person said it would take two to three weeks. Would you feel comfortable working under the circumstances if you were in a similar situation? By the way, my inclination during the surgical consultation would be to attempt to confirm that what I have really is a hernia. Other than that, if I have an inguinal hernia, I'd want it repaired because I don't want to have to avoid tons of exercises due to a fear of harming myself. Thanks for the help anyone is able to give me.

I have an inguinal hernia and will have surgery in a couple months (laparoscopic). I’ve been able to workout successfully with minimal issues. However, I use (and highly recommend) a hernia belt/truss when I go to the gym or plan to do anything lifting around the yard/house. They are cheap and readily available on Amazon.

 

[keengkong]

I have an inguinal hernia and will have surgery in a couple months (laparoscopic). I’ve been able to workout successfully with minimal issues. However, I use (and highly recommend) a hernia belt/truss when I go to the gym or plan to do anything lifting around the yard/house. They are cheap and readily available on Amazon.

Thanks. Amazon will deliver the hernia belt on Monday.

 

[keengkong]

Get a proper diagnostic workup. If a hernia is confirmed and you wish to continue weight training, I recommend having it repaired sooner rather than later. At the age of 56 on a fit individual with your goals, a Lichtenstein repair or TEP would be my preferred option.

Whether to choose an open Lichtenstein procedure or a minimally invasive TEP (totally extraperitoneal) repair should, in this case, depend on the experience of the surgeon. In my opinion, a surgical robot is unnecessary. A laparoscopic TEP repair provides excellent results, as does the Lichtenstein technique.

The use of a da Vinci system, compared to standard laparoscopic TEP surgery, offers no real advantage here. On the contrary, operating with the da Vinci system requires significant experience and, in my opinion, may be disadvantageous due to the longer operating time.

Inform yourself about both the Lichtenstein and TEP techniques and make your decision based on the expertise of the surgeon. Have the procedure performed in a certified hernia surgery center with a high procedural volume and proven experience.

What is a proper diagnostic workup? I will get it repaired soon. What types of certifications, if any, should I demand of a surgeon? Is there a minimum number of surgeries per year or other metric that you'd use to know to know whether the surgeon is properly qualified? What organizations should I rely on to certify a hernia surgery center? I did get several hyperlinks and downloaded a few scholarly articles but so far haven’t really read them yet. I’m far better at finding scholarly articles than interpreting scientific articles. Still I’ll make some attempt at figuring this stuff out. It seems like it shouldn’t be that hard to find a good inguinal surgeon since it’s a common surgery.

 

[keepbashing]

What is a proper diagnostic workup? I will get it repaired soon. What types of certifications, if any, should I demand of a surgeon? Is there a minimum number of surgeries per year or other metric that you'd use to know to know whether the surgeon is properly qualified? What organizations should I rely on to certify a hernia surgery center? I did get several hyperlinks and downloaded a few scholarly articles but so far haven’t really read them yet. I’m far better at finding scholarly articles than interpreting scientific articles. Still I’ll make some attempt at figuring this stuff out. It seems like it shouldn’t be that hard to find a good inguinal surgeon since it’s a common surgery.

Where do you live? I’m familiar with the certification of hernia centers in Germany, and to some extend in Europe. It should be a board-certified specialist in visceral surgery. In my opinion, a hernia specialist should perform at least 100 hernia operations per year. If it’s a center where the surgeon also handles other types of cases, then at least 50 per year.
If it’s going to be a TEP or Lichtenstein procedure, the surgeon should have performed each of these operations at least 100 times.

Yes, it’s a common procedure, but the outcome can vary greatly depending on the surgeon’s skill and experience.

As I mentioned in my previous message:
Clinical examination, ultrasound, and, if in doubt, MRI are the options for diagnosis. A CT scan can be omitted.

An inguinal hernia cannot be treated conservatively, except by avoiding strain. However, it does not get smaller and will not close on its own.

Clinical examination, ultrasound, and, if in doubt, MRI are the options for diagnosis. A CT scan can be omitted.

If you are young and want to continue strength training, you won’t be able to avoid surgery IF it's an inguinal hernia.

Depending on your age, I would recommend a Lichtenstein operation, or if you are young and plan to support healing with HGH and GLOW, a Shouldice operation. Personally, I prefer to operate on young, athletic patients with good connective tissue using the Shouldice technique, as it results in fewer long-term issues such as irritation or loss of sensation. However, the success of this surgical technique is extremely dependent on the surgeon. Only a truly experienced surgeon who has performed a large number of Shouldice operations will be able to achieve a good outcome.

 

[keengkong]

I live in Fresno, California, in the US. I live about 3-4 hours away from the medical schools at UCLA, Stanford, and UC San Francisco.

I look fondly on the few weeks that I spent mainly in Gottingen, Germany 35 years ago. I had a 30 x 20 cm piece of the fence that separated East and West Germany that I cut off with the help of German friend, but my Mom saw it while cleaning her attic and decided to throw it away. I probably should have labeled it. In the US, non-scientists are terrible at the metric system; I had to convert those measurements.

 

[keengkong]

Where do you live? I’m familiar with the certification of hernia centers in Germany, and to some extend in Europe. It should be a board-certified specialist in visceral surgery. In my opinion, a hernia specialist should perform at least 100 hernia operations per year. If it’s a center where the surgeon also handles other types of cases, then at least 50 per year.
If it’s going to be a TEP or Lichtenstein procedure, the surgeon should have performed each of these operations at least 100 times.

Yes, it’s a common procedure, but the outcome can vary greatly depending on the surgeon’s skill and experience.

As I mentioned in my previous message:
Clinical examination, ultrasound, and, if in doubt, MRI are the options for diagnosis. A CT scan can be omitted.

It looks like in the US that the main certification organization for hospitals that perform hernia surgeries is the Surgical Review Corporation (SRC), which names a certified hospital as being a "Center for Excellence in Hernia Surgery." The hospital closest to me bears that designation. The American College of Surgeons provide a similar certificate however it seems the "Center for Excellence" designation is the one that the hospitals brag out. I found some organizations that are supposed to have the better hernia surgeons however I haven't figured out yet whether being a member of these organizations is a sign of quality or is merely a form of marketing. If I don't learn anything else, I'll at least know to confirm that the hospital is a Center for Excellence and that my surgeon has performed the number of surgeries that you recommended. I'm probably best off not thinking much about this until I meet with the surgeon to whom I was referred and I at least confirm that I do in fact have a hernia.

 

[Liter O' Test]

you got some pain during squats and immediately thought it was cancer?
then within 24 hours you went to urgent care and despite her saying it was OK you are planning where to get your surgery done?

dude you gotta chill out, this is absolutely bonkers

many people get this pain and they just avoid hurting it and it goes away on its own, its basically a strain,so stop feeling yourself up like a tramp

 

[keepbashing]

U prefer to not read the whole text, do you? @Liter O' Test
Or maybe you missed this part:
"She said she believes it's likely that I have a hernia but that the tissue went back inside."

Which indeed is very likely from what he wrote and experienced. He also plans, as I recommended, to have the diagnostics done at a hernia center, which is highly advisable since smaller hernias are often difficult to detect.

So I am not sure how you came to the conclusion that he’s having surgery tomorrow morning, especially since no surgeon, at least not here in Germany, and I’m sure even less so in the U.S. would perform a hernia operation without first confirming the suspected diagnosis. That’s not only standard practice but also a legal requirement.

 

[keepbashing]

I live in Fresno, California, in the US. I live about 3-4 hours away from the medical schools at UCLA, Stanford, and UC San Francisco.

I look fondly on the few weeks that I spent mainly in Gottingen, Germany 35 years ago. I had a 30 x 20 cm piece of the fence that separated East and West Germany that I cut off with the help of German friend, but my Mom saw it while cleaning her attic and decided to throw it away. I probably should have labeled it. In the US, non-scientists are terrible at the metric system; I had to convert those measurements.

Crazy! I actually worked at the university hospital in Göttingen a few years ago. It’s a beautiful city, in my opinion.
It’s a pity about the souvenir. I think parts of the Berlin Wall are also sold as keepsakes, especially in Berlin.

I appreciate your effort man

That sounds reasonable, let him go through with the diagnostic workup first, and then you can take it from there. If it turns out to be a small hernia, you can ask for his opinion on TEP versus Lichtenstein and which procedure he prefers and performs more frequently.

 

[Liter O' Test]

So I am not sure how you came to the conclusion that he’s having surgery tomorrow morning, especially since no surgeon, at least not here in Germany, and I’m sure even less so in the U.S. would perform a hernia operation without first confirming the suspected diagnosis. That’s not only standard practice but also a legal requirement.

lmao why even write this crap out dude, go back to reddit

 

[keepbashing]

lmao why even write this crap out dude, go back to reddit

Because you’re obviously a complete layperson when it comes to medical matters, and he described quite typical symptoms along with a doctor’s assessment that it might indeed be a small hernia. Recommending not to have this medically examined and diagnosed is, at best, naive - and at worst, pure ignorance.

Most important: he asked. And as it happens, that’s actually my field of expertise.

I’ll leave Reddit to you. I think you fit in there better than I do.

 

[keengkong]

Because you’re obviously a complete layperson when it comes to medical matters, and he described quite typical symptoms along with a doctor’s assessment that it might indeed be a small hernia. Recommending not to have this medically examined and diagnosed is, at best, naive - and at worst, pure ignorance.

Most important: he asked. And as it happens, that’s actually my field of expertise.

I’ll leave Reddit to you. I think you fit in there better than I do.

I was extremely happy to place a post here and to in turn receive the advice of an actual expert. I have gone to doctors before concerned before that I had something serious and it turned out to be nothing. I have also had doctors act surprised that I had not come in earlier for things and had them tell me that I wasn't taking things seriously enough. The responses I received here show both the good and bad sides of Meso. On one hand, I get responses from folks who are extremely knowledgeable. Who would have thought that folks injecting themselves with steroids are actually quite smart and know about the risks of what they're doing? And that so many of the folks would spent a great deal of time writing to some stranger in a foreign country trying to help them? On the other hand, Meso brings out a bunch of people who are quick to criticize and are trying to prove that they're the smartest person in the room. My own experience is that folks trying to prove that they're the smartest people in the room seldom are.

Why did I write that I was immediately concerned that I might have cancer? Because that was my actual thought. I could write that I immediately, based upon my superior knowledge, knew I had an inguinal hernia. However, in actuality if someone had asked me where on the body an actually hernia occurs, I wouldn't have been able to correctly guess that. When I see Leo's Vitruvian Man painting, it takes a great deal of effort for me to see the hernia.

 

[keengkong]

For anyone interested,in looking at scholarly articles on inguinal repair surgeries, I collected some for my own use. All hyperlinks are to full text, paywall-free versions of the articles. These articles are tough reading if you, like me, are not involved in medicine.

The basic surgical repair options are open surgery without use of mesh; open surgery with use of mesh; laparoscopic; and robotic.

I've attached a picture of Leonardo DaVinci's Vitruvian Man, a drawing that shows a man with a hernia. I believe because of that drawing a common robot for performing surgery is called a Da Vinci.

To become a "master surgeon" in hernia repair with the Surgical Review Corporation and to maintain that certification, the surgeon must perform a minimum of 90 hernia surgeries per year, among other requirements. https://surgicalreview.org/wp-content/uploads/2022/10/MS-Hernia-One-Pager-101322.pdf. Most hernia surgeons are not master surgeons. However, your outcome will likely be better if you go to a surgeon who performs large numbers of hernia surgeries. That's my two cents based upon what I heard. I'm just a patient and I have to seen my own hernia surgeon, although I have an appointment scheduled.

Alam & Sheen (2021). Total extraperitoneal hernia repair and its associated pitfalls. Mini-invasive Surgery 5, 48.

American Hernia Society (2018). Mesh Advisory Statement [it's generally in favor of using mesh when performing hernia surgery].

Arnoldo, et al. (2024). Abdominal Wall Hernias—State of the Art of Laparoscopic versus Robotic Surgery. J. Personalized Med. 14(1), 100 ["Results indicated similar short-term outcomes for robotic and laparoscopic techniques in inguinal hernia repair, with robotic groups experiencing less postoperative pain"].

Awad (2024). A comparative study between open pre‑peritoneal approach versus laparoscopic trans‑abdominal pre‑peritoneal approach in recurrent inguinal hernia repair - a prospective cohort study. Hernia 26, 629-635.

Bhattacharya & Bhattacharya (2024). Can robotic and laparoscopic inguinal hernia repair ever replace Lichtenstein repair[Q] Hernia 28(4), 1487–1488.

Bulyk, et al. (2023). The history of inguinal surgery. Rozhl Chir. 102, 149-153.

Choi, et al. (pre-publication, 2025). Robotic Transabdominal Preperitoneal Inguinal Hernia Repair Is Feasible and Efficient - A Prospective Cohort Study of a Day-Only Protocol From a High-Volume Robotic Surgery Centre Evaluating Short-Term Outcomes. ANZ J. Surgery 95(10), 2097-2103.

Dreifus, et al. (2022). Robotic inguinal hernia repair - is the new Da Vinci single port platform providing any benefit[Q] Surgical Endoscopy 37, 2003-2013.

Haladu, et al. (2022). Open versus laparoscopic repair of inguinal hernia - an overview of systematic reviews of randomised controlled trials. Surgical Endoscopy 36, 4685-4700.

HerniaSurge Group (2018). International guidelines for groin hernia management. Hernia 22, 1-165.pdf

Huerta & Garza (2025). A Systematic Review of Open, Laparoscopic, and Robotic Inguinal Hernia Repair - Management of Inguinal Hernias in the 21st Century. J. Clin. Med. 14(3), 990.

Jafar, et al. (2024). Analysis of Conflicts of Interest in Studies Related to Robotics in Gastrointestinal and Abdominal Wall Surgery. J. Am Coll. Surgeons 238(1), 54-60.

Kudsi, et al. (2023). Comparison of perioperative and mid-term outcomes between laparoscopic and robotic inguinal hernia repair. Surgical Endoscopy 37(2), 1508-1514.

Lee, et al. (2023). How to do a single-port robotic totally extraperitoneal (TEP) inguinal hernia repair using the da Vinci SP platform. ANZ J. Surgery 93(5), 1357-1359.

Love & Carbonell (2024). Robotic Inguinal Hernia Repair - Current Status. Curr. Surgery Rep. 12, 448-454.

Patel & Wright (2021). Controversies in Inguinal Hernia. Surg. Clins. N. Am. 101(6), 1067-1079.

Prabhu, et al. (2020). Robotic inguinal vs transabdominal laparoscopic inguinal hernia repair - the RIVAL Randomized Clinical Trial. Jama Surgery 155(5), 380-387.

Ramser, et al. (2021). Robotic hernia surgery I. English version - Robotic inguinal hernia repair (r‑TAPP). Video report and results of a series of 302 hernia operations. Der Chirurg 92(Suppl 1), 1-13.

https://www.aafp.org/pubs/afp/issues/2020/1015/p487.html (Shakil, et al. (2020). Inguinal Hernias - Diagnosis and Management. Am. Fam. Physician 102(8), 487-492).

Solaini, et al. (2022). Robotic versus laparoscopic inguinal hernia repair - an updated systematic review and meta-analysis. J Robotic Surgery 16(4), 775-781.

Stabilini, et al. (2023). Update of the international HerniaSurge guidelines for groin hernia management. BJS Open 7(5), zrad080.

https://www.mdpi.com/2077-0383/14/14/4875https:/www.mdpi.com/2077-0383/14/14/4875 (Tigora, et al. (2025). Modern Perspectives on Inguinal Hernia Repair - A Narrative Review on Surgical Techniques, Mesh Selection and Fixation Strategies. J. Clin. Med. 14(14), 4875).

Visconte, et al. (2025). Robotic inguinal and umbilical hernia repair - clinical outcomes, costs, and future perspectives - narrative review. J. Robotic Surgery 19, 642.

Xie, et al. (2024). The evolution of minimally invasive inguinal hernia repairs. Annals Laparoscopic & Endoscopic Surgery 9, 13.

American Hernia Society [membership merely requires fee payment & unrestricted license to practice surgery].


Video from AHS on questions to ask your doctor.