The first step in hernia surgery, whether open or closed, is the surgeon making an incision over the inguinal region, according to NHS Choices. Open inguinal surgery requires the surgeon to make a single incision measuring between 2 and 4 inches long in the groin area, while a closed inguinal surgery requires three small incisions in the abdomen.
The next step in open inguinal hernia surgery depends on the behavior of the hernia, as stated by WebMD. If the hernia bulges through the wall of the abdomen, the surgeon pushes the hernia back into the groin before closing up the incision. On the other hand, if the hernia goes down the inguinal canal, the surgeon pushes back the hernia sac or ties it off and removes it. If the hernia is large or a recurring one, the surgeon uses mesh patches to repair it.
Closed inguinal hernia repair uses small incisions, a telescope and mesh patches, according to Sages. The surgeon inserts a tiny telescope connected to a special camera through a hollow tube. This scope allows the surgeon to view everything on a video screen. The surgeon accesses the inguinal area through the three incisions. Once inside, the surgeon uses staples, sutures or adhesive sealant to place the mesh over the hernia defect.