Carlos Rodriguez, DO, MBA, FACSHernia & Gallbladder Surgery
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Condition guide

Inguinal Hernia

What an inguinal hernia is, why it happens, and the two ways it can be repaired.

Written and reviewed by Carlos Rodriguez, DO, MBA, FACS. Last reviewed October 1, 2026.

The short version

  • An hernia is a groin bulge from tissue pushing through a natural weak spot, often with discomfort when lifting, coughing, or straining.
  • It will not heal on its own; both open and robotic repair reinforce the weak spot with .
  • Which approach fits you depends on your anatomy, hernia size, surgical history, and preference. The comparison table below puts them side by side.
  • Most patients go home the same day with either approach.

A quick summary. The full details are below, and none of it replaces an exam.

What is an inguinal hernia?

An inguinal hernia happens when tissue, often part of the intestine or surrounding fat, pushes through a weak spot in your lower abdominal wall, in the groin area. This creates a bulge, and often discomfort or pain, especially when lifting, coughing, or straining. Not every ache in that area means you have a hernia, which is why an exam matters.

Close-up drawing of the inguinal canal from the front with the spermatic cord running through it. One hernia pushes up through the floor of the canal. The other comes through the internal ring on the middle side of the cord.
Where a groin hernia forms: (1) through the floor of the canal, or (2) through the internal ring.

Why does this happen?

The groin area naturally has a passage called the inguinal canal. While a baby is developing, this canal is where the testicles travel down into the scrotum (in males). That process leaves a natural weak spot in the abdominal wall for everyone, which can widen over time or under strain.

Three types of hernia in this area

  • Indirect inguinal hernia: the most common type. Often present from birth, it follows the same path the testicles took during development.
  • Direct inguinal hernia: develops later in life from general wear and weakening of the abdominal wall muscles.
  • : less common, and located just below the main inguinal area, near the blood vessels that travel into the thigh. This type is more common in women.

See it happen: the testicle's trip and the two kinds of hernia, step by step ↓

Can I wait to fix my hernia?

If your hernia does not bother you, waiting is a safe choice. This is called watchful waiting. When a hernia causes no symptoms, the medical risk of waiting is low.

A hernia will never heal on its own. Surgery is the only way to fix it.

If your hernia is getting bigger, I recommend fixing it sooner. A smaller hernia is easier to repair, and the recovery is easier too. Waiting adds little medical risk, but a larger hernia can change the operation you need and how long it takes to recover.

Two ways this is repaired

Dr. Rodriguez repairs inguinal hernias either robotically or through a traditional open incision, depending on your anatomy, hernia size, prior surgical history, and your own preference. Both approaches use mesh to reinforce the repair. Choose a guide below for the full details on each.

Table comparing the two repairs. How I get there: through the groin with open, through the abdomen with robotic. Recovery: slower with open, faster with robotic. Pain after surgery: more with open, less with robotic. At six weeks: the same place either way. Chance it comes back: less than 2 percent with both. Nerve block after surgery: yes with both.
Open and robotic repair, compared.

Robotic vs. open repair, side by side

Robotic-Assisted Repair Open Repair
Incisions Three incisions, about 1cm each One incision, about 10cm, just above the groin crease
Anesthesia General anesthesia Typically general anesthesia
Hospital stay Most patients go home the same day Most patients go home the same day
Bladder catheter Sometimes used during surgery to keep the bladder empty Not used
Return to work and normal activity Generally shorter than open repair Generally takes a bit longer than minimally invasive repair
Lifting limit after surgery Nothing over 10 pounds until your 2 week visit, when we reassess Nothing over 10 pounds until your 2 week visit, when we reassess
Closure Absorbable stitches under the skin and waterproof skin glue, no staples or visible stitches Absorbable stitches under the skin and waterproof skin glue, no staples or visible stitches
Water on incisions Shower the day of surgery, pat dry. No soaking in a tub or pool for 4 weeks Shower the day of surgery, pat dry. No soaking in a tub or pool for 4 weeks
Nerve block for pain Often given near the groin nerves Often given to numb the groin nerves

Source for return-to-work comparison: SAGES patient education materials.

Minimally Invasive

Robotic-Assisted Repair

Three small incisions in the upper abdomen, a 3D console-guided view, and a same-day recovery for most patients.

Read more →
Traditional

Open Repair

A single incision directly over the hernia, done under local, regional, or general anesthesia. Also typically a same-day procedure.

Read more →
Animated guide

The testicle's trip, two hernias, and the open repair

Where an inguinal hernia comes from, and how I fix it through an open incision, in ten steps. Press Next step to go at your own pace, or Play all to watch it straight through.

Animation in ten steps: the testicle descends from beside the kidney, through the internal inguinal ring, along the inguinal canal and out the external ring into the scrotum, bringing its artery, veins, nerves, vas deferens and cremasteric fibers with it. Then a direct hernia, an indirect hernia, and the open mesh repair. The caption under the drawing describes each step. Edge of the ribs Kidney Internal ring External ring Scrotum Inguinal canal Testicle The whole trip The canal, up close Toward the middle of your body → The finished open repair: mesh on the floor of the inguinal canal, under the spermatic cord, with its two tails wrapped around the cord.
Your right side is shown. Simplified, not to scale.

Step 1 of 10

Beside the kidney

Before you were born, your testicle started out inside your abdomen, right next to the kidney.

Read the whole script

  1. Step 1. Beside the kidney

    Before you were born, your testicle started out inside your abdomen, right next to the kidney.

  2. Step 2. The trip down

    It traveled down the back wall of the abdomen. As it went, the kidney drifted up a little. The artery that feeds the testicle comes off the aorta, and its veins drain back to the vena cava, so both came down with it.

  3. Step 3. Through the internal ring

    It left the abdomen through an opening in the muscle wall called the internal inguinal ring. The vas deferens, the tube that will carry sperm, came up from the pelvis and joined it on the inner side. On the way through, it picked up muscle fibers from the internal oblique. Those are the cremasteric fibers.

  4. Step 4. Along the canal

    Then it traveled along a tunnel called the inguinal canal. A skin nerve, the ilioinguinal nerve, joined it here and rides on top of the cord. Another skin nerve, the iliohypogastric, runs just above the canal. Behind the cord, the internal ring closed down snugly.

  5. Step 5. Out the external ring

    It left the canal through a second opening, the external inguinal ring.

  6. Step 6. Home

    Its final resting place is the scrotum. Everything it brought with it is now the spermatic cord. Cut across, the cord holds the vas deferens on the inner side, the artery near the middle with the veins around it, the nerve on top, and the cremasteric fibers wrapped around the outside. Sometimes some fat comes through the outer part of the ring too. That is called a cord lipoma.

  7. Step 7. Hernia 1, the floor gave way

    Here is where one kind of hernia comes from. It has nothing to do with the testicle's trip. Wear and tear over the years, from exercise, from work, from lifting, and the floor of the canal gives way. A bulge pushes up through the floor. This is a direct inguinal hernia, hernia number 1 on my map.

  8. Step 8. Hernia 2, the ring did not close

    The other kind goes back to the trip. If the internal ring did not close properly, a small pocket of the abdominal lining can slip out through it, right next to the cord. Over the years it works its way down the canal. This is an indirect inguinal hernia, hernia number 2 on my map. Believe it or not, this is by far the more common kind. It does not matter which kind you have. I fix them both the same way.

  9. Step 9. The open repair: moving the cord

    In the open repair, I place a soft rubber drain called a Penrose around the cord and move it a little to the side. That gives me room to work on the floor of the canal underneath it.

  10. Step 10. The mesh

    A large piece of mesh goes on the floor of the canal, under the cord. I start at the pubic tubercle with two stitches. One anchors a running stitch that holds the lower edge to the inguinal ligament. Separate stitches hold the upper edge to the muscle arch. The two tails of the mesh wrap around the cord, cross, and are stitched together. That rebuilds the internal ring.

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