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All seven Medical Spheres ›A soft bulge in the groin that appears when coughing or lifting: this is usually how an inguinal hernia shows itself. It is repaired either openly through a small incision or minimally invasively from the inside – in both cases with a mesh.
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Rules of thumb from the Bürgerspital. You will discuss your personal plan in the preliminary consultation.
The inguinal hernia
No hernia of the abdominal wall is more common than the inguinal hernia, also known as a groin hernia. In the area of the inguinal canal, the abdominal wall gives way and the peritoneum pushes outwards through the gap – the hernial orifice – often followed by fatty tissue, sometimes by a loop of bowel. Men are affected much more often than women: in men, the spermatic cord runs through the inguinal canal, which therefore forms a natural weak point.
A typical sign is a soft swelling that becomes more noticeable when standing, coughing or straining and often recedes when lying down. Many people feel a pulling or pressing sensation that increases with exertion, and a feeling of heaviness towards the evening; in men, the discomfort can radiate into the scrotum. Some hernias go unnoticed for a long time and are only discovered during an examination.
An inguinal hernia cannot regress; if anything, it gets bigger over time. Even so, not every hernia has to be operated on straight away: the international HerniaSurge guideline, endorsed by the German Hernia Society, explicitly names watchful waiting as an option when symptoms are absent or mild. If the hernia limits you at work, during sport or in everyday life, that speaks in favour of surgery – at an early stage, the procedure is usually smaller.
Women have a femoral hernia more often than men; it emerges just below the inguinal ligament. Its hernial orifice is narrow, and tissue becomes trapped there more easily. In women, a swelling in the groin region should therefore be checked promptly.
The procedures
With the TAPP technique, the gap is closed from the inside through a few small openings and the abdominal wall is reinforced with a mesh. This is particularly suitable for hernias on both sides and for recurrences after open surgery.
With the Lichtenstein technique, the hernia is exposed through an incision in the groin and covered tension-free with a mesh. The technique is suitable, for example, after major abdominal operations or when general anaesthesia is to be avoided.
The mesh takes tension off the suture and lowers the risk of a recurrent hernia. The aim is full resilience at work, during sport and in everyday life.
The path
The timing depends on your symptoms, the findings and your life situation. The procedure is chosen together.
Physical examination standing and lying down, often while coughing or straining. An ultrasound shows the size and contents of the hernia.
Watch or operate: if symptoms are mild, waiting is an option; if the hernia is limiting you, surgery is planned.
The procedure, anaesthesia and possible complications are discussed, after which the date is set.
Minimally invasive or open, in each case with a mesh. Getting up with assistance is possible on the day of the operation; you go home the same day or after a few days.
Walks and light activities are encouraged; painkillers on a fixed schedule make it easier to move. When coughing, light counter-pressure on the wound with the flat of the hand provides relief.
Physical work, heavy lifting and strength training return gradually, usually after four to six weeks and after medical clearance.
Statutory, private, self-pay
Statutory health insurance
If the operation is medically indicated, German statutory health insurance covers it as a standard benefit; there is no application procedure for this. A referral from your GP or specialist is usually sufficient for the consultation.
Operations covered by statutory health insurance take place at the Bürgerspital Wertheim, an acute care hospital with a public healthcare mandate.
Private insurance or self-pay
Private health insurers cover the medically necessary operation according to the terms of the policy. Privately insured and self-pay patients can also be treated at the Main-Tauber-Klinik, the private clinic in the same building.
At the Bürgerspital, an upgraded room is available on request, subject to availability.
Specialists
Inguinal hernias are operated on by specialists from general and abdominal surgery at the Bürgerspital, who form the hernia team. All four also work at the Main-Tauber-Klinik.
Locations
Each clinic shows on its own website how the treatment works there.
Germany
The Bürgerspital and the Main-Tauber-Klinik are under one roof; hernia surgery at the Bürgerspital holds the DHG seal, and patients with statutory health insurance are also operated on there.
Frequently asked questions
Not always straight away. If you have hardly any symptoms, the hernia can initially be monitored by a doctor – provided you know the warning signs of it becoming trapped. If it bothers you in everyday life, surgery is the reliable solution.
According to the HerniaSurge guideline, both approaches are well supported by evidence; the endoscopic technique often allows a faster return to everyday life. The deciding factors are the findings, previous operations and the question of anaesthesia – as well as experience with the chosen procedure.
In adults, mesh reinforcement is standard. The synthetic mesh spreads the load over a large area, grows into the tissue and significantly lowers the risk of a recurrent hernia.
At a desk, usually after one to two weeks; with physical work later, often after four to six weeks. You can drive again once you no longer need strong painkillers and can make an emergency stop without restriction – for many, after a few days to about a week.
Possible complications include bruising and swelling, in men also of the testicles, wound infections, bleeding and, rarely, injury to nerves or the spermatic cord. A pulling or numb sensation can persist for a few months and usually passes; rarely, groin pain lasts longer. Even with a mesh, a recurrent hernia cannot be completely ruled out.
When the bulge suddenly can no longer be pushed back, becomes hard and very tender, and nausea or vomiting set in. Trapped tissue may then have a poor blood supply: go to an emergency department immediately or call an ambulance on 112.
At best, it holds the hernia back temporarily, but it does not close the gap and does not prevent it from becoming trapped. It is therefore no longer considered a treatment; it is at most an option when surgery is not possible.
Yes, if it is medically indicated – statutory and private insurers cover it. No application is needed; bring your health insurance card and, if you have one, the referral to your appointment.
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This was the best decision I have ever taken for myself. The whole experience has changed my life for the better. From the first consultation I felt welcomed and treated very well. I did not feel alone during the journey because the team were just a WhatsApp away and they made regular check-ups on me. Thank you for everyone at the hospital from the staff to the doctors, you are all amazing.
Weight Doctors South AfricaWow, was für ein erster Eindruck! Dr. Frank Gruner, dessen Professionalität von jahrelanger Erfahrung zeugt, war äußerst verständlich und menschlich (was mir sehr wichtig war). Er verstand meine Bedürfnisse, und seine Erklärungen und Anweisungen entsprachen genau meinen Vorstellungen. Die Patientenberaterin Jennifer war mit ihrem Charme ebenfalls eine große Hilfe und erklärte mir alles Notwendige und den weiteren Ablauf. Auch die Mitarbeiter am Empfang waren sehr höflich und freundlich. Ich melde mich nach der Operation mit meinen Eindrücken zurück. Vielen Dank an alle!
Westfalenklinik Fachklinik für Plastische und Ästhetische Chirurgie · Original in GermanIch habe eine Unterlidstraffung machen lassen und bin mit dem Ergebnis sehr zufrieden. Mein Dank geht vor allem an Frau Dr. Simidjiiska für ihre Fürsorge, Kompetenz und Empathie. Aber auch das gesamte Team der Klinik macht einen hervorragenden Job!
Westfalenklinik Fachklinik für Plastische und Ästhetische Chirurgie · Original in GermanIch bin rundum begeistert von meiner Erfahrung in dieser Haartransplantationsklinik. Von der ersten Kontaktaufnahme bis zur Nachsorge war alles hervorragend organisiert und professionell. Das gesamte Team war unglaublich freundlich, hilfsbereit und zuvorkommend. Man hat sich jederzeit gut aufgehoben und ernst genommen gefühlt. Besonders positiv fand ich, dass sich alle Mitarbeiter ausreichend Zeit genommen haben, um meine Fragen zu beantworten und jeden Schritt verständlich zu erklären. Auch der Service war erstklassig. Die Organisation, die Betreuung vor und nach dem Eingriff sowie die Kommunikation waren wirklich hervorragend. Das gesamte Team hat einen sehr kompetenten und gleichzeitig menschlichen Eindruck gemacht. Die Klinik selbst ist modern, sauber und sehr gut ausgestattet. Während der Behandlung wurde äußerst sorgfältig und professionell gearbeitet, und ich hatte zu jedem Zeitpunkt das Gefühl, in guten Händen zu sein. Ein großes Dankeschön an das gesamte Team für die tolle Betreuung und den freundlichen Umgang! Ich kann die Klinik absolut weiterempfehlen und bin mit meiner bisherigen Erfahrung sehr zufrieden. Wer Wert auf Professionalität, Qualität und einen hervorragenden Service legt, ist hier meiner Meinung nach bestens aufgehoben.
Westfalenklinik Fachklinik für Plastische und Ästhetische Chirurgie · Original in GermanBisher war es nur ein Beratungsgespräch aber es war sehr gut.
Weight Doctors Group · Original in GermanIch fand, dass der Arzt gut und verständlich erklärt hat. Ich habe diese Woche noch einen Termin in einer anderen Klinik, da ich mich gründlich informieren möchte; auch der Preis wird dabei eine Rolle spielen – darüber bin ich ganz offen.
QUOLE Medisch Centrum · Original in GermanHervorragende Behandlung. Von der ersten Beratung bis zur Nachsorge hat mir Dr. Koch stets ein sehr gutes Gefühl vermittelt. Ich litt jahrelang unter einer echten Gynäkomastie, nach der OP kann sich das Ergebnis sehen lassen, mein Selbstbewusstsein ist endlich zurückgekehrt. Ich kann die Alster Klinik jedem empfehlen, der schon lange mit dem Gedanken spielt sich operieren zu lassen.
Alster-Klinik Hamburg · Original in GermanDr. Schubert gab mir das Gefühl, in genau der richtigen Praxis zu sein für mein Anliegen. Ich habe mich beim Beratungsgespräch sehr wohl gefühlt und verstanden gefühlt.
Alster-Klinik Hamburg · Original in GermanÜber die ehrliche Einschätzung
Alster-Klinik Hamburg · Original in GermanIch habe mich sehr wohl geführt, das Gespräch war sehr gut, die Ärztin hat mir sehr ausführlich alles erklärt und bin mit einem sehr guten Gefühl nach Hause gegangen.
Westfalenklinik Fachklinik für Plastische und Ästhetische Chirurgie · Original in GermanIch bin eine sehr ängstliche Person. Bei Herrn Dr. Neis habe ich mich sofort wohlgefühlt. Behandlungsgespräche, Umgang, Freundlichkeit – es passt alles. Ich kann ihn ohne Bedenken und Einschränkung nur weiter empfehlen. Dankeschön Herr Dr. Neis für die tolle Arbeit.
CGCE Group · Original in GermanDr. Klarner ist sehr nett, hat mich sehr gut beraten und aufgeklärt. Ich hab mich gut aufgehoben gefühlt, vielen Dank!
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