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Bilateral Inguinal Hernia Repair — One Anaesthetic, Two Sides, One Recovery

Centre in Ahmedabad · Apollo Hospital, Bhat, Gandhinagar · Gota OPD, Ahmedabad

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You came in with a lump in one groin. Then you were told there is one on the other side too. Or a scan found a second gap you had never felt. The question now is not whether to repair it. It is whether to fix both sides together, in one anaesthetic, or one at a time. That choice changes the approach, where the mesh goes, and how long you are off work. This page explains how the choice is made, what happens on the day, and when it is better to wait.

Dr Harsh Shah repairs groin and abdominal wall hernias at Apollo Hospital, Bhat, Gandhinagar. He sees patients at the Gota OPD in Ahmedabad. He is trained in surgical gastroenterology. Groin hernias are repaired by keyhole and robotic surgery as routine work. For each side, the operation note records the gap, the layer and the mesh used. Anyone who examines you years later will know exactly what was done.

Dr Harsh Shah, hernia surgeon, Ahmedabad

Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Hernia Surgeon
· Apollo Hospital, Bhat, Gandhinagar · Gota OPD, Ahmedabad
★★★★★ 4.9 · 200+ Google reviews

Call +91 63555 64601 WhatsApp your scan or examination note

Last updated: 04 Oct 2026 · Reviewed by Dr Harsh Shah, MS, MCh (GI), DrNB (GI) · Gujarat Medical Council Reg. No. G-38738

ગુજરાતીમાં વાંચો: ગુજરાતી · हिंदी में पढ़ें: हिंदी

Both sides together, or one at a time?

Most people with a hernia on both sides can have both fixed in one keyhole operation. The same three small cuts reach both groins, so there is one recovery.

A groin hernia is a gap in the floor of the groin. Fat, or a loop of bowel, pushes out through it. When there is a gap on each side, the body is the same. But the choice of operation changes a lot. This is because the two kinds of repair reach the groin from opposite sides.

An open repair reaches each groin from the front. Each side needs its own cut in that groin. So two sides means two cuts, two sore areas and two sets of nerves in the way. It is a sound operation that has been done well for decades. For a single hernia it is still a good choice. Done twice, its drawbacks double.

A laparoscopic or robotic repair reaches the groin from behind, from inside the belly. It uses three small cuts near the navel, away from the groins. Here is the point that decides most cases with two hernias: the same three cuts reach both groins. The second side adds a mesh and some time. It adds no new wound and no second recovery. That is why hernia guidelines name hernias on both sides as a clear reason to repair from behind.

Open repair compared with repair from behind, when both sides need fixing
Open repair (from the front)Laparoscopic or robotic repair (from behind)
CutsOne cut in each groinThree small cuts near the navel, shared by both sides
Where the mesh liesIn front of the groin floorBehind the muscle, covering all three hernia routes
AnaestheticLocal, spinal or generalGeneral
RecoveriesTwo sore groinsOne recovery for both sides
Often chosen whenGeneral anaesthetic is unsafe, or the space behind is badly scarredBoth sides need repair, or a front repair has come back

Where the mesh goes, and why the layer matters more than the mesh

The mesh is laid behind the muscle, where one flat sheet on each side covers every route a groin hernia can take. The layer matters more than the brand.

Every modern groin hernia repair uses a mesh. A repair that relies only on stitches under tension comes apart more often. What separates one repair from another is not the brand of mesh. It is the layer it is placed in.

The layer. In the repair from behind, the mesh lies behind the muscle and in front of the thin lining of the belly. Every groin hernia must pass through this space. There are three routes: beside the cord, through a weak floor, and lower down near the thigh. One flat sheet in this space covers all three. So one operation can fix a different type of hernia on each side, with no change of method. In an open repair, the mesh sits in front of the floor. It works well, but it guards the route it covers rather than the whole area.

The mesh itself. A light, wide-pored plastic mesh is the usual choice. Wide pores let tissue grow through the mesh, which keeps the groin supple. Heavy, tightly woven meshes were given up because they left the groin stiff. The sheet is cut large, so it lies well past the gap on every side. A mesh that is too small, or that does not reach far enough towards the middle, is the most common reason a repair fails. Where the two sheets meet near the middle, they overlap so no gap is left.

Fixing the mesh in place. A well-sized sheet in this space is held by the pressure of the belly itself. For smaller gaps it often needs no fixing at all. For a large gap it may be fixed with glue or tacks that dissolve. There are two areas where nothing is ever placed. One carries the nerves to the thigh. A tack there can cause pain that lasts longer than the hernia did. The other covers the large blood vessels to the leg. Keeping clear of both is a set step of the operation.

Laparoscopic, robotic or open — choosing for your groins

Laparoscopic repair is the standard way to fix both sides from behind. It uses the shared three cuts described above.

Robotic repair is the same operation, with instruments that bend and a magnified 3D view. It helps most when a large gap needs fine stitching deep in the pelvis, or when scar tissue from past surgery must be freed with care. There is a fuller page on robotic inguinal hernia surgery in Ahmedabad. It is not offered as better for every patient, because the evidence does not show that.

Open repair is kept for when a general anaesthetic is unsafe, or the space behind the muscle is too scarred to open safely.

When surgery is not advised, or not yet

A hernia with no symptoms at all. A small groin hernia that you cannot feel, that does not ache and does not limit you, may be watched. Long-term studies of men watched this way show that the feared emergency is uncommon. That emergency is a loop of bowel trapped and cut off from its blood supply. Many do come to surgery later, because the hernia grows or starts to ache. Waiting does not make that operation harder. Watching is not the same as being left alone. You are examined, told which symptoms mean come back the same day, and reviewed.

Not if it cannot be pushed back. Some hernias are repaired rather than watched, because the risk of an emergency is real. These include a hernia that will not go back in, and one that has caused pain with vomiting and a swollen belly. A hernia lower down, near the thigh (a femoral hernia), is also repaired.

Not before the cause of the strain is treated. A hernia is a sign of a wall under load. Constipation, a prostate that makes you strain to pass urine, a long-standing cough and smoking all pull at a fresh repair. These are treated first where possible. Stopping smoking before surgery is part of the treatment, not just general advice.

Not while something more important is unexplained. Weight loss you cannot explain, a change in bowel habit, or anaemia on a blood test are checked first. They come before a planned hernia repair, not after it.

Not both sides together, in some cases. Sometimes a heart or chest problem makes the shortest anaesthetic the priority. Sometimes the pelvis is badly scarred. Sometimes one groin needs an open repair and the other does not. In these cases the sides are done separately. The side with symptoms goes first, and the other once you have recovered. You will be told plainly if any of these applies to you.

What patients say

★★★★★

“My mother recently underwent hernia surgery at Apollo Hospital, Gandhinagar under the care of Dr. Harsh J. Shah, and my mother recovering very well. Dr. Harsh Shah is a highly skilled and compassionate surgeon. He explained everything clearly, made my mother feel comfortable throughout the treatment, and performed her surgery with great care. The nursing staff and the entire hospital team were polite, attentive, and provided excellent hospitality from admission to discharge. I sincerely thank Dr. Harsh Shah and the entire Apollo Hospital team for their outstanding care. I highly recommend Dr. Harsh Shah for hernia surgery and Apollo Hospital, Gandhinagar for their excellent medical service”

Sanju Kukda · Google review

Your patient journey — five steps

  1. Book your consultation. Bring any ultrasound or CT, your list of medicines, and a note of how the lump behaves. Does it appear when you stand? Does it go back when you lie down? Does it ache by the end of the day? Both groins are examined standing and lying, whatever you came in for.
  2. Tests, and the plan for each side. Most groin hernias need no scan, because the examination makes the diagnosis. An ultrasound or CT is asked for when the examination is unclear, when the lump may be something else, or when a past repair must be mapped. Fitness tests for anaesthesia are arranged as needed. You leave knowing which sides will be repaired, by which route, and what happens if a hidden gap is found.
  3. The surgery. Under general anaesthesia, through three small cuts near the navel. Each hernia is pushed back, and a mesh is laid on each side. Fixing both sides takes much less than twice as long as one, because the approach is shared.
  4. A short hospital stay. This is planned as day care: most people go home the same day. You go home once you can walk, eat and pass urine, with tablets, warning signs and your review date.
  5. Follow-up and full healing. You are reviewed at about one week for the wounds and again at about six weeks. Walk from day one, as much as you like. Most people return to desk work within a week. Drive once you can brake hard without pain. Heavy lifting and gym work build back up from about six weeks, when the mesh has grown in.

The day of surgery, hour by hour

This is what a repair of both sides looks like on the day at Apollo Hospital, Bhat. The times are rough; the order is not.

  1. On arrival, early morning. Admission and insurance forms are completed, you change, and the anaesthetist sees you. Both groins are examined again and both are marked. Marking, not memory, prevents surgery on the wrong side. You walk to the theatre.
  2. The operation. Under general anaesthesia. Three small cuts near the navel. The space behind the muscle is opened on both sides, each hernia is pushed back, and a mesh is laid on each side. The lining is closed over the mesh. A urine tube is not used routinely.
  3. Two to four hours later. You walk to the toilet with help. Passing urine is the test for going home. The surgery is close to the bladder, so short-lived trouble passing urine is a little more likely when both sides are done. Light food follows once you have kept water down.
  4. Four to eight hours later, home. The groins and scrotum are checked for swelling. Your pain is checked sitting and standing. You go home with tablets, a list of warning signs, your review date and a phone number that is answered. Someone should travel home with you and stay with you that night.

Cost, insurance and admission

Groin hernia repair is covered by most health insurance, with cashless admission at Apollo Hospital, Bhat. State in the request that both sides will be repaired.

Groin hernia repair is covered by most health insurance policies. Cashless admission is available at Apollo Hospital, Bhat. Pre-approval is sought with the examination findings and any scans attached. The request states that both sides are to be repaired. A second side added at the last minute is the usual reason a claim is questioned. Our coordinator handles the request and tells you what is approved before admission. There is a fuller note on hernia surgery and your insurance claim, and on anaesthesia for hernia surgery if that is what worries you.

Recovery, what can go wrong, and the honest part about recurrence

The usual course. Moving from sitting to standing, and coughing, feel sore for several days. Bruising and swelling of both groins, and of the scrotum in men, appear around day two or three. It looks worse than it is, and fades over a few weeks. A firm swelling where the hernia used to be is usually fluid, called a seroma. It settles on its own. Draining it invites infection, so it is watched unless it is painful or growing.

Short-lived trouble passing urine is the problem most linked to repairing both sides from behind. The surgery runs across the front of the bladder on both sides. It settles, sometimes after a urine tube for a day or two. It is why you go home only after passing urine.

Lasting groin discomfort is the risk to weigh, more than the hernia coming back. A small number of people have aching, burning or numbness in the groin or inner thigh long after healing. The repair from behind keeps the mesh away from the nerves at the front of the groin, which helps. But it does not remove the risk. Tacks placed in the wrong area are a cause that can be avoided. There is a separate note on groin pain that lasts after hernia surgery, and what can be done about it.

The hernia coming back, stated plainly. A mesh repair of the right size, in the right layer, comes back in only a small number of people. When it does, the cause can usually be found. The mesh may have been too small, or not reached far enough towards the middle. It may have rolled or folded. A second gap on the same side may have been missed. Or heavy lifting started before the mesh had grown in. Smoking, ongoing straining and naturally weak tissue raise the risk, and the first two are in your control. A hernia that comes back after a repair from behind is usually fixed from the front, and the other way round. That is why the operation note on the layer and mesh matters years later.

Less common problems are named, not hidden. The bladder or bowel can be injured during surgery, and this is repaired at the same time. There can be bleeding, with bruising that spreads to the scrotum. Infection is uncommon when the cuts are small and away from the groin. The blood supply of the testis or the sperm tube can be injured, and the testis can swell afterwards. Gas pain or shoulder-tip pain can last a day or two after any keyhole operation.

Questions patients ask

The doctor found a hernia on the other side that I have never felt. Must it be repaired?

Not always. A small gap with no symptoms can be watched. The case for fixing it now is that the cuts and the space are already open. The case against is that a silent hernia may stay silent, and every repair carries a small risk of lasting discomfort. You decide this in the consultation, and it is written into the consent form. No such choice is made while you are asleep.

Will I need mesh on both sides?

Yes. Each side that is repaired gets its own sheet. The with-or-without-mesh note explains why repairs without mesh are kept for special cases. A permanent plastic mesh is avoided only where bowel has had to be removed and the area is not clean.

I have had a prostate operation. Does that change things?

It can, so please mention it. Past prostate surgery or radiotherapy scars the same space where a repair from behind is done. Sometimes that space can still be opened safely. Sometimes an open repair on each side is better. It means you need your own plan. It does not mean the hernias cannot be fixed.

Is the lump in my groin definitely a hernia?

Not always. A swollen lymph gland, fluid around the testis, or a strain where the muscles attach at the groin can all look like one. There are separate notes on what a lump in the groin can be and on why a sports hernia is not an inguinal hernia.

What are the warning signs I should not wait on?

A lump that has become hard and painful and will not go back in. This is more serious with vomiting, a swollen belly, or no passing of wind. It can mean a loop of bowel is trapped. It is an emergency. Go to the hospital; do not wait for an appointment.

Where Dr Harsh Shah sees and operates

Dr Harsh Shah — Gota OPD, Ahmedabad
SF-203, 2nd Floor, Olive Greens, Sarkhej–Gandhinagar Highway, Gota, Ahmedabad, Gujarat 382481
Directions to the Gota OPD · +91 63555 64601

Dr Harsh Shah — Apollo Hospital, Bhat, Gandhinagar
Plot No. 1 A, Apollo Hospital International Limited, GIDC Bhat Industrial Estate, Gandhinagar, Gujarat 382428
Directions to Apollo, Bhat · +91 63555 64601

More on this site: robotic inguinal hernia surgery · hernia surgery at Dr Harsh Shah’s practice · what each week of recovery looks like

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