Laparoscopic Hernia repair

A hernia is a sac formed out of lining of body cavity that comes out through the hole or weak area in the body wall. Sometimes an organ like bowel can get trapped in hernia cavity causing block or cut off of blood supply needing urgent operation.

Largest body cavity is in the abdomen and there are number of weak spots in the tummy you can get hernias. Common places to get hernias are in the regions of groin, upper thigh, around the belly button and in and around the previous operation sites. Hernia will not get better by itself and may need to be treated surgically as they have a high risk of bowel getting trapped inside. A hernia repair is usually performed as a day surgery and you will be able to go home within 24 hours of admission to the hospital. The operation may be performed as an “open” or “keyhole” (laparoscopic) surgery.

In open hernia repair, an incision is made on the groin (abdomen) and the bulge is pushed back into place. Repair is performed by reinforcing the defect with synthetic mesh. You will not be able to perform activities like heavy lifting for few weeks.

Laparoscopic Hernia Surgery

In Laparoscopic or key hole hernia surgery, hernia is visualized within the body using a laparoscope and other instrument are passed through two or three 5 mm cuts in the body wall. The laparoscope is a small fiber-optic viewing instrument with light source and video camera attached to its end.

Advantages over an open surgery

  • Less post-operative pain with smaller incisions and faster recovery
  • No further incisions required for patients with hernias in both groins (bilateral hernia)
  • Ideal method for patients with recurrent hernias after previous surgery
  • Early discharge from hospital
  • Earlier return to work

Laparoscopic surgery is performed in a hospital operating room under general anesthesia. The television camera attached to the laparoscope displays the image of the abdominal cavity on a television screen. The surgeon makes three small incisions over the abdomen to insert the balloon dissector and trocars (keyholes). A deflated balloon along with the laparoscope is inserted and the balloon is inflated with a hand pump under direct vision. Once the trocars (key holes) are placed, the keyhole instruments are then inserted to repair the hernia. A sheet of mesh is inserted in through the top key hole and positioned and fixed it in the abdominal wall to reinforce the repair and help prevent recurrent hernias. After completion of the repair the CO2 gas is evacuated and the trocars are removed and the tiny incisions are closed and dressed with a sterile bandage.

Specific complications of laparoscopic hernia surgery may include local discomfort and stiffness, infection, damage to nerves and blood vessels, bruising, blood clots, wound irritation and urinary retention.

Post Operative Guidelines

  • Pain medication will be provided and should be taken as directed
  • Remove the bandage after 24 hours
  • Swelling in the groin, at the site of hernia may occur due to serum accumulation in the cavity left by reducing the hernial sac
  • Bruising usually appears in the genital area, which is not painful and disappears over 1-2 weeks
  • You are able to drive and resume normal activities when comfortable unless otherwise instructed
  • Make a follow up visit 7 to 10 days after surgery to monitor your progress