For a femoral hernia are there alternatives to surgery?

Not really.: Femoral hernias are unique in that they have a high propensity to incarcerate, meaning that something can get "stuck" within the hernia. For this reason, i always recommend surgical repair unless someone has a prohibitively high risk for surgery. In contrast, small inguinal hernias that are not causing symptoms may sometimes be safely watched.

Yes: There are a variety of techniques for both open and laparoscopic approaches. Almost all use mesh, which is considered by most surgeons to be superior to sutures only for a femoral hernia. Whatever approach the surgeon is best at however is probably going to yield the best result.