Childhood inguinal (groin) hernia repair (Paediatric inguinal herniotomy)
A common children's operation to close a small passage in the groin that lets the lining of the tummy, and sometimes a loop of bowel, bulge through and form a lump.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- A groin hernia in a child does not get better on its own, so an operation is recommended once it is found.
- It is usually arranged within a few weeks because, occasionally, the bowel can become trapped — a painful emergency.
- Most children have a quick recovery and are back to nursery or school in about a week.
- Very young or premature babies are watched more closely and often stay in hospital overnight after the anaesthetic.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Removes the groin lump and the discomfort it can cause
A simple umbilical (tummy-button) hernia, which usually closes on its own and is managed differently.
Your child wakes on the ward and is offered a drink and something to eat once ready. They may be a little drowsy, clingy or unsettled from the anaesthetic.
Clear, written advice on pain relief, wound care, bathing and return to nursery/school.
Your child wakes on the ward and is offered a drink and something to eat once ready. They may be a little drowsy...
Some children feel sick after the anaesthetic. Pain is usually mild and controlled with regular paracetamol (and...
Keep the wound clean and dry — usually no bath or shower for two days, then gentle washing is fine. The area may...
Most children are comfortable and back to nursery or school, and can return to normal play and gentle activity.
What is a childhood inguinal (groin) hernia repair?
An inguinal hernia is a lump in the groin (or scrotum in boys) that appears when a small passage left over from before birth does not close. The lining of the tummy, and sometimes a loop of bowel, slides through this passage and forms a bulge that is often more obvious when your child cries, coughs or strains.
The operation, called a herniotomy, finds this passage and closes it with a stitch. In children this is usually all that is needed — unlike in adults, a mesh is not normally used.
Unlike an umbilical (tummy-button) hernia, a groin hernia in a child does not close on its own and is repaired once found. This is because there is a risk the bowel can become trapped (incarcerated) and have its blood supply squeezed (strangulated), which is an emergency. For this reason the operation is usually arranged within a few weeks rather than left.
Types & techniques
There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Open repair (herniotomy)
The surgeon makes a small cut in the groin crease, finds the passage (hernia sac) and closes it with a stitch. The most common method in children.
Laparoscopic (keyhole) repair
Done through tiny cuts, one near the tummy button and sometimes one or two lower down, using a small camera. May be chosen in some children, including girls or where both...
Repair of both sides
If a hernia is present, or likely, on both sides, both can sometimes be repaired in the same operation. Your surgeon will discuss this.
Emergency repair
If a hernia becomes trapped and cannot be gently pushed back, an urgent operation is needed to free the bowel and repair the passage.
Preparing for your surgery
- Consent for the operation is usually given by a person with parental responsibility. An older child or young person who is able to understand what the operation involves may be able to give consent for themselves; the exact legal rules differ a little in Scotland from England, Wales and Northern Ireland. Whatever your child's age, they should be involved as much as they can be and their own views and agreement (assent) sought. Ask the team anything you are unsure about first.
- Follow the fasting (nil by mouth) instructions in your letter exactly — if your child eats or drinks too close to the operation it may be delayed or cancelled for safety.
- Tell the team if your child has a cold, fever or is unwell on the day, was born prematurely, or has any other health problems.
- Mention all medicines, allergies and any previous problems with anaesthetics in the family.
- Bring comfort items — a favourite toy, dummy or blanket — and clothing that is easy to get on and off around the groin.
- Plan for one parent to stay with your child where allowed, and arrange care for siblings.
- Ask whether your child is likely to be a day case or may need to stay overnight.
What happens
The operation is done under a general anaesthetic, so your child is asleep and feels nothing. You can usually stay with them until they are asleep, and be there as they wake up.
For an open repair, the surgeon makes a small cut in a crease in the groin, gently finds the passage (the hernia sac) and closes it with a stitch. The skin is usually closed with dissolvable stitches and skin glue or tape, so there are no stitches to remove. The operation generally takes about an hour.
Afterwards your child recovers on the ward. Once they are comfortable, awake and have had a drink, most can go home the same day. Very young or premature babies are often kept in overnight so their breathing and recovery can be monitored.
Is this operation right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- A simple umbilical (tummy-button) hernia, which usually closes on its own and is managed differently.
- A child who is acutely unwell with another illness on the day, when elective surgery is best delayed.
- A trapped, strangulated hernia, which is not an elective case but a surgical emergency needing immediate care.
- Situations where an anaesthetic carries added risk and a specialist children's setting with paediatric anaesthesia is needed.
Delay surgery if…
- Your child has a fever, cold, chest infection or is otherwise unwell on the day.
- The fasting instructions were not followed, for safety with the anaesthetic.
- There is a recent vaccination or illness your team advises waiting after.
- A premature baby is not yet at a stage where anaesthesia is felt to be safe — but trapped hernias must not be delayed.
Alternatives to discuss
- Urgent surgery rather than waiting if the hernia becomes trapped or strangulated.
- Watchful waiting is generally not advised for groin hernias because they do not resolve and can become trapped.
- Choosing an NHS pathway, which is the usual route, rather than private care.
- A specialist paediatric centre if your child is very young, premature or has other health needs.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Anaesthetic choices
The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.
Benefits
- Removes the groin lump and the discomfort it can cause
- Greatly reduces the risk of the bowel becoming trapped or strangulated
- Usually a single, definitive operation that does not need to be repeated
- Quick recovery for most children
- In children, repair does not normally need mesh
Risks & complications
- Soreness or bruising around the wound for a day or two
- Feeling sick for the first day after the anaesthetic
- Mild swelling or firmness around the wound or scrotum that settles
- Wound infection, usually treated with antibiotics
- A collection of fluid or blood (seroma or haematoma) around the wound or in the scrotum
- The hernia coming back (recurrence)
- Injury to the tube (vas deferens) or blood vessels to the testicle in boys, which can rarely affect that testicle
- The testicle ending up higher than before and needing attention
- Injury to nearby structures such as the ovary or fallopian tube in girls if they are involved in the hernia
- A rare reaction to the general anaesthetic, especially in very young or premature babies
Serious problems are uncommon, but two worth understanding are recurrence and, in boys, a small risk of injury to the vas or blood vessels close to the hernia sac. This usually would not affect overall fertility because the other side continues to work normally. Very young and premature babies have a slightly higher anaesthetic risk and so are monitored more closely. Ask your surgeon how often they do this operation in children.
Published figures to discuss
Serious complications are uncommon, but rates depend on the child's age, whether they were premature, and whether the hernia was trapped. The figures below are cautious ranges from paediatric sources and should be discussed with your surgeon, who can give their own results for children of your child's age.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Recurrence of the hernia | Roughly 1–2% in reported series | Higher in babies born very prematurely and after an emergency (trapped) repair. | European Paediatric Surgeons' Association — guideline on paediatric inguinal hernia (PubMed)pubmed.ncbi.nlm.nih.govPublished figure |
| Wound infection | Around 1% in reported series | Usually settles with antibiotics. | European Paediatric Surgeons' Association — guideline on paediatric inguinal hernia (PubMed)pubmed.ncbi.nlm.nih.govPublished figure |
| Injury to the vas or testicular vessels (boys) | Uncommon; reported low single-digit percentages in some series | May rarely affect that testicle; the other side normally continues to work, so overall fertility is usually unaffected. | European Paediatric Surgeons' Association — guideline on paediatric inguinal hernia (PubMed)pubmed.ncbi.nlm.nih.govSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
Recovery — what to expect, and when
Children, especially babies and toddlers, usually bounce back quickly. The wound is small and most are back to their normal selves within a few days, with full healing over a couple of weeks.
- Being a bit clingy, tired or off their food for a day after the anaesthetic
- Mild soreness around the wound that eases with paracetamol
- Some bruising or swelling around the groin or scrotum that settles over days
- A small, slightly firm ridge under the wound as it heals
- Quickly returning to normal play within a few days
Aftercare
- Give regular pain relief such as paracetamol (and ibuprofen if advised) for the first day or two as needed.
- Keep the wound clean and dry; avoid baths and swimming for the time your team advises (often about two days, then gentle showering).
- Let any dissolvable stitches, glue or tape come away on their own — do not pick at them.
- Encourage calm play at first and avoid rough or straddling activities (like bikes or climbing frames) for a week or so, or as advised.
- Dress your child in soft, loose clothing that does not rub the wound.
- Offer plenty of fluids and a normal diet once they are eating again.
- Keep any follow-up appointment, and know who to contact if you are worried.
- Child's paracetamol (and ibuprofen if advised) at home and in date
- Soft, loose clothing that won't rub the groin
- Fasting instructions from the letter understood and followed
- Time off nursery/school planned (about a week)
- Comfort item (toy, blanket, dummy) packed
- Care arranged for any siblings
- Ward or clinic contact number saved for problems
Scars and how they heal
The cut is small and placed in a natural groin crease, so the scar usually becomes faint over time. Closed with dissolvable stitches and glue or tape, there are normally no stitches to remove. Keyhole repairs leave only tiny marks. The scar can look pink or slightly raised at first and fades over months.
⚠ Get urgent help if…
- Your child is in a lot of pain that pain relief does not help
- A high temperature that does not come down with paracetamol, or your child seems generally unwell
- The wound becomes increasingly red, hot, swollen or starts to ooze
- A new firm, tender lump in the groin or scrotum that will not go back, especially with vomiting (possible trapped hernia — seek urgent help)
- Repeated vomiting, a swollen tummy or not passing stool
- Your child is unusually drowsy, floppy or hard to wake, or has any breathing difficulty (seek emergency help)
- In boys, a very swollen, hard or discoloured scrotum
Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A good result is a flat groin with no more lump, a comfortable child and a small wound that heals neatly. The operation usually fixes the problem in one go and most children never have any further trouble.
Surgery cannot completely guarantee the hernia will never come back, and a hernia can occasionally appear on the other side later. Your surgeon will explain what to look out for.
For most children the repair is permanent and they go on to lead completely normal lives. Recurrence is uncommon but a little more likely in babies born very prematurely. Occasionally a hernia develops on the opposite side at a later date, which would be a separate, new problem rather than the original repair failing.
Combining with other procedures
If a fluid swelling around the testicle (a hydrocele) or an undescended testicle is found at the same time, the surgeon may deal with it during the same operation. If there is reason to think both sides are affected, both groins may be repaired together. Your surgeon will discuss anything extra before the operation.
Follow-up & long-term care
Many children do not need a routine follow-up appointment and are simply reviewed if there are concerns; some units offer a check by phone or in clinic. Dissolvable stitches and glue come away on their own. Contact the ward or your team if the wound looks infected, your child is in unrelieved pain, or a new lump appears in the groin.
Revision and secondary surgery reality
- Recurrence is uncommon but, if it happens, a further repair is needed.
- A hernia can appear on the opposite side later — a new problem rather than failure of the first repair.
- A fluid swelling (hydrocele) can sometimes appear after surgery and often settles on its own.
- Rarely the testicle sits higher afterwards and needs review.
Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.
What good aftercare looks like
- Clear, written advice on pain relief, wound care, bathing and return to nursery/school.
- A named contact and a route to be seen quickly if the wound looks infected or a new lump appears.
- Specific 'come back now' instructions for a trapped hernia, persistent vomiting or an unwell child.
- Appropriate monitoring after the anaesthetic for very young or premature babies.
- A plan for review if there are any concerns, even where routine follow-up is not needed.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The paediatric surgeon's fee and experience
- The paediatric anaesthetist's fee (a general anaesthetic is always needed)
- Theatre and hospital facility fees
- Whether one or both sides are repaired
- Open versus keyhole technique
- Whether an overnight stay is needed (more likely for young or premature babies)
- Follow-up appointments if required
- The surgeon's and paediatric anaesthetist's fees
- Theatre and facility fees, and any overnight stay
- Whether the quote covers one or both sides
- Pre-operative assessment and any tests
- Follow-up appointment(s) and aftercare advice
- What happens — and who pays — if a complication arises or the hernia recurs
- The cancellation policy, including if your child is unwell on the day
On the NHS? Childhood inguinal hernia repair is a routine NHS operation, usually arranged within a few weeks of diagnosis because of the risk the hernia could become trapped; families sometimes choose private care for timing or choice of surgeon.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not explaining that, unlike a tummy-button hernia, this one will not close on its own.
- Underplaying the small but important risk to the vas or vessels in boys.
- No clear plan for what to do if the hernia becomes trapped before the operation date.
- Unclear fasting instructions, which can lead to last-minute cancellation.
- No written aftercare advice or emergency contact for parents.
Marketing red flags
- Suggesting a groin hernia in a child can simply be watched and will close on its own.
- “No-risk” or “completely pain-free” claims for surgery under general anaesthetic.
- Offering surgery for very young or premature babies outside a proper paediatric anaesthetic setting.
- Not mentioning that the hernia could rarely come back or appear on the other side.
Choosing a surgeon safely
- Check your surgeon is on the GMC Specialist Register for this area.
- Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
- You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
- Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- Is my child likely to go home the same day or stay overnight?
- Will the repair be open or keyhole, and why?
- Is there any sign the other side is affected too?
- What pain relief should I give at home, and for how long?
- What exactly should make me bring my child back urgently?
- How often do you do this operation in children of my child's age?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my operation, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this operation not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Will the hernia get better without an operation?
Why does it need doing fairly soon?
Does my child need to stay in hospital?
When can my child go back to nursery or school?
Will it affect my son's fertility?
Are there stitches to take out?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: Great Ormond Street Hospital — Inguinal hernias and hydroceles Sheffield Children's NHS — Repair of inguinal hernia (herniotomy) BAPS — Management of paediatric hernia (clinical update) European Paediatric Surgeons' Association — guideline on paediatric inguinal hernia (PubMed) Hernia recurrence after inguinal hernia repair in children (PubMed) AAP — Assessment and management of inguinal hernias in children Scottish Government — children's consent (Children (Scotland) Act 1995 guidance) Welsh Government — children's consent when engaging specialist services
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
Related guides: Childhood umbilical (tummy-button) hernia repair · Hydrocele repair · Circumcision (adult) · Buried penis / penile condition surgery · Hypospadias repair