Founded in 1945, Shouldice Hospital is the global leader in hernia repair. Our 99.5% lifetime success rate for primary inguinal hernias sets the gold standard for medical professionals around the world.
Over 70 years of clinical evidence clearly demonstrates that the Shouldice surgical procedure is exceptionally safe and the repair is secure and reliable. Our rate of infection, complications and recurrence is less than 0.5% for primary inguinal hernia repairs. This is the lowest recorded rate in the world. If you think you have a hernia, we offer a walk-in clinic for your convenience. We always recommend that you come to the clinic for an examination, if at all possible. Our hernia surgeons have years of specialized training and experience and are available during clinic hours to provide an expert diagnosis. Our walk-in clinic is available at no direct cost to our patients. If you live more than 1 hour (100 km/60 miles) away from Shouldice, you can submit a medical questionnaire for our surgeons to review.
At Shouldice, we deliver a quality of care to hernia patients that cannot be found anywhere else in the world.
Are You Experiencing Hernia Pain?
The most common symptom of a hernia is a soft swelling or bulge under your skin. The type of hernia you have will determine where the bulge appears on your body. Some hernias can only be seen when you stand up and may disappear completely when you lie down. Others may only be visible when you strain your muscles by coughing, sneezing, bending or lifting. Usually, the bulge is soft enough that you can gently push it back into your abdomen and often is not there when you wake up in the morning.
Most hernias do not cause painful symptoms. Sometimes, the area around your hernia may be tender and you may feel some sharp twinges or a pulling sensation. As your hernia gets bigger, your pain and discomfort may increase. If it is not repaired, a hernia may eventually prevent you from enjoying normal activities, such as exercising, grocery shopping or having sex.
If you have a hernia, contact your doctor right away if:
- Your hernia becomes very painful
- Your hernia can‘t be pushed back into your abdomen
- And you feel sick to your stomach (nauseated) or vomit or have a fever
Types of Hernias
It‘s not always easy to diagnose a hernia. Every year, over 1,000 patients come to the Shouldice Hospital, convinced that they are experiencing hernia symptoms when, in fact, they really have a groin strain. Surgery may not be the right solution for these patients. If you think you might have a hernia, come to the Shouldice Hospital walk-in clinic for an examination. The highly specialized Shouldice surgical team diagnoses and treats thousands of hernias every year. They have the expertise to provide a proper diagnosis and may help you avoid an unnecessary operation.
Our hernia surgeons have experience repairing hernias and providing hernia treatment for:
- Inguinal Hernia
- Indirect Inguinal Hernia
- Direct Inguinal Hernia
- Femoral Hernia
- Epigastric Hernia
- Incisional Hernia
- Umbilical Hernia
The Shouldice repair is internationally recognized as one of the safest and most effective techniques for repairing hernias. When performed by a specially trained and well-experienced Shouldice hernia surgeon, this pure, natural tissue repair virtually eliminates complications or repeat hernias (recurrences). The Shouldice repair combines a proven surgical technique with the powerful benefits of the body‘s own natural healing ability. This results in a secure, reliable repair and a rapid, comfortable recovery for our patients. For over 70 years, our hernia surgeons have maintained a success rate of 99.5% on primary inguinal hernias– an accomplishment that sets us apart from any other medical facility.
Natural Tissue Repair vs. Mesh Repair
Discover The Shouldice Difference!
The Shouldice repair combines a proven surgical technique with the powerful benefits of the body‘s own natural healing ability. Our hernia surgeons overlap each layer of the abdominal wall, using a technique that puts no tension on the natural tissue. By overlapping these layers of muscle and tissue, we are able to strengthen and reinforce the weak spot where the hernia developed. Natural tissue repair results in secure, reliable repair and a rapid, comfortable recovery for our patients. Almost all 95% of the operations at Shouldice are conducted using only a local anesthetic, a light (sedative) and a pain pill (analgesic). Additional medication is provided when necessary. This reduces the risk of complications, shortens recovery time and helps make the experience more comfortable.
Experienced Hernia Surgeons
Every surgeon on the Shouldice team focuses their professional time, training and expertise on the successful lifelong repair of external abdominal wall hernias. On average, Shouldice surgeons perform up to 700 hernia operations a year, giving them the experience and skills to expertly manage even the most complex hernia repair. In total, the Shouldice surgical team has performed well over 380,000 hernia operations to date. When it comes to successful hernia surgery, there is simply no substitute for experience.
- Do I need a referral to come to Shouldice Hospital?
No, you do not need a referral or an appointment for a hernia examination at Shouldice. All you have to do is come to our walk-in clinic for a hernia examination. Or, if you live more than one hour away from the hospital (60 miles/100 km), simply complete the medical questionnaire and fax, mail or e-mail it to us for review.
- How quickly can I arrange for an operation?
First, you must have an examination at our hospital or submit a completed medical questionnaire for review by one of our surgeons. Admission dates are scheduled as conveniently as possible and we will make every effort to accommodate your preferred admission date. Please keep in mind that your admission will depend on the space we have available and on specific medical criteria, such as your general health, your weight and the status of your hernia.
- How do I get the medical questionnaire?
Long distance or international patients have five options:
- You can go online to complete the medical forms provided on our website.
- You can copy the online forms to a word file, complete them and email them back to us at firstname.lastname@example.org
- You can print the forms off our website and send them to us by fax or regular mail.
- We can fax the blank forms to you if you have a fax machine.
- We can put the blank forms in today’s mail and you can expect to receive them in 7 to 10 days.
- I have pain and swelling in my groin. Do I have a hernia?
Pain and swelling in the groin can have many different causes. A hernia can sometimes be quite difficult to identify and diagnose. In fact, over 1,000 patients a year come to Shouldice, convinced that they have a hernia when they really have a groin strain. If you think you have a hernia, come to our walk-in clinic for an examination by one of our hernia specialists. They have the experience and expertise to give you a proper diagnosis and may even be able to help you avoid an unnecessary operation.
- Do you treat all types of hernias at Shouldice?
- indirect and direct inguinal hernias
- recurrent hernias
- femoral hernias
- epigastric hernias (sometimes known as ventral hernias)
- incisional hernias
- umbilical hernias
However, there are several types of hernias that we do not repair. If you have one of the following hernias, contact your doctor for treatment or referral to an appropriate specialist:
- Hiatal or hiatus hernia In this type of hernia, the stomach bulges up into the chest through the hiatus. The hiatus is an opening where the esophagus (food pipe) passes through to connect the throat to the stomach.
- Parastomal hernia A parastomal hernia occurs when part of the intestine bulges through the abdominal muscles around a stoma. A stoma is an artificial opening in the abdomen, used to transfer waste products, such as feces or urine, to a small pouch outside the body. A stoma may be necessary for people with certain types of medical conditions, such as bowel cancer, Crohn’s disease or kidney disease.
- Herniated disc The bones in the spine are cushioned by soft, spongy discs. When one of these discs is damaged, some of the soft, inner material may bulge out, causing back pain and irritation. This is known as a herniated or ruptured disc.
- Flank or lumbar hernia This type of hernia is fairly rare and usually develops after an operation or injury to the side of the abdominal wall. It usually causes pain in the low back and leg.
- Sports Hernia This condition, known also as Gilmore’s Groin, is not actually a hernia, but more of a severe groin strain and can be treated with therapeutic management. It may not require surgery.
- Why do I have to stay at Shouldice for a few days after my surgery?
The patient-centred recovery program at Shouldice has been specially designed to promote healing in hernia patients. You should plan to stay at Shouldice for about 3 nights after surgery to take part in this program.
During your recovery, our nurses will provide the specialized care you need to avoid any post-surgical complications. Most complications develop in the first 48 hours after surgery and a short hospital stay alleviates any concerns or anxiety for patients and their families. You will also get the rest, nutrition and exercise necessary for healthy healing. More importantly, you‘ll enjoy a confident recovery with a rapid return to normal activities. You‘ll meet other patients who have been through the operation already and are happy to reassure you and answer your questions. Peer-to-peer mentoring is important because it relieves stress and promotes a positive attitude to recovery. We have found that this unique approach to post-operative treatment is the best way to prepare patients for a quick return to a normal lifestyle.
- Can my spouse or partner stay at the hospital?
Your spouse or partner cannot stay at the hospital but we will provide a list of local hotels and bed and breakfasts for you.
- Can I bring my motorhome?
Yes, but we do not have any hookups.
- How much does the operation cost?
- For registered Ontario patients, medical and surgical fees are covered by OHIP.
- For other insured Canadians, except PEI residents, fees are partially covered by inter-provincial insurance plans.
- Most private insurance plans will pay for the semi-private accommodations at Shouldice.
- Shouldice has agreements with US insurers to help our American patients.
- International patients pay by credit card, bank note, cash or certified cheque and then receive paper work from us to secure reimbursement from their insurance provider, where available.
- Will you take payment from my insurance company? Or, how do I pay?
Insurance companies in Canada cover the semi-private accommodation fee for hospital stays. For Canadian patients coming to Shouldice, costs for examinations and surgery are covered fully (Ontario) or in part (rest of Canada) by provincial health plans. We deal with many insurance companies, most of which cover the semi-private cost. You will have the option of paying for your semi-private accommodation by cash, debit card, or credit card. The hospital will complete all the necessary paperwork and have it ready for you to submit to your insurance company as soon as you are discharged from the hospital.
International patients pay by cash, credit card, bank note or certified cheque for all services and accommodations. Paper work is provided at Shouldice Hospital for international patients to secure reimbursement from their insurance provider.
- How long does the surgery take?
Most hernia repairs take an average of 45 minutes.
- Can I drive home after I’m discharged?
In most cases, yes. We always recommend that you have a driver pick you up after your stay but some of our patients do drive home. If you are driving any distance, you may wish to pull over and stretch every so often. If you are flying, stand up in the aisle for a stretch and short walk.
- How soon can I return to work?
You can return to work as soon as you feel up to it. Most people are back at work within 8 to 10 days.
- When can I return to my normal activities?
Many of our patients are back to their normal routines within a week. We encourage you to be active and enjoy gentle exercise as soon as possible after your operation. We even provide a putting green, shuffle board and pool tables for you to use while you are our guest. However, we always encourage you to start slowly and use good judgment. Too much vigorous activity too soon may cause some discomfort but will not damage your repair.
- My doctor says that he does the ‘Shouldice Repair’ or the ‘Canadian Method.’
At Shouldice Hospital, we set high standards. Our surgeons are fully qualified and licensed to perform surgery by the appropriate Canadian authorities. Then they are required to spend up to 6 months of intensive training in the Shouldice Technique to perfect their skills before they are approved to lead a Shouldice surgical team. Only surgeons practicing at Shouldice Hospital receive this training. The Shouldice technique is very detailed and must be practiced in high volumes to ensure consistently superior results.
Most general surgeons will repair 20 to 30 hernias in a year. Shouldice surgeons average over 700 cases a year, which provides the highest level of practice and experience in the world. This is why Shouldice surgeons are the world‘s most experienced leaders in hernia repair.
Surgeons come from around the globe to observe the Shouldice technique. For two or three days, they can watch as the Shouldice repair is performed by Shouldice specialists. However, this is not training. Although many surgeons perform hernia repairs, we cannot offer a training program for them. As a result, we cannot guarantee the quality of any hernia repair said to be a Shouldice repair, when it is performed by doctors outside of our hospital.