Open or conventional hernia repair

Inguinal hernia

Laparoscopy Hernia Surgery

Laparoscopy hernia surgery or laparoscopic herniorraphy is the repair of a hernia defect on the abdominal muscle wall using minimally invasive or key-hole surgery techniques.

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What is an Inguinal hernia?

An inguinal hernia is a hernia in the groin. A hernia is a weakness or hole in the abdominal muscle wall through which abdominal contents (often the intestines or other parts of the bowel) protrude causing a bulge. Men are far more likely to develop a hernia than women (98% of people who develop an inguinal hernia in their groin are male) and up to third may occur on both sides of the abdomen.

Can a hernia heal by itself?

A hernia cannot get better or heal with medications. If left untreated, hernias can develop complications. The only way to correct a hernia is through Hernia Surgery.

Surgical options for inguinal hernia

Open hernia surgery

What is laparoscopy surgery?

How is Laparoscopic hernia repair performed?

External view

Internal view

When can usually daily activities be resumed?

Return to normal routines can be expected within 1-2 weeks but care in not lifting heavy loads must be observed for at least 6-8 weeks.

This is no different from open inguinal hernia surgery as both procedures depend upon the natural body healing process to grow over the hernia mesh in order to return to normal strength.

What are the side effects?

Local discomfort and stiffness recover after 2-3 weeks. Twinges of pain are uncommon but can occur on exertion for up to six months after the procedure and would diminish eventually.

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Updated 10 Nov 09

S H HO UROLOGY AND LAPAROSCOPY CENTRE

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Inguinal hernia surgery can be done by an urologist or general surgeon. Our urology centre practices the Totally Extraperitoneal (TEPP) approach, which is the one of the latest and favored laparoscopy hernia surgery technique today. In this method, the inguinal hernia is accessed without reaching the abdomen cavity (pre-peritoneal space) and the mesh is fixed to cover the weakened area. TEPP decreases the risk of damage to internal organs and vascular injuries.

Surgical repair of inguinal hernia using mesh, which is a thin, plastic sheet, is the procedure of choice worldwide. Mesh can be inserted by conventional (open) or laparoscopy (key-hole) surgery. Laparoscopy hernia surgery is preferred over open surgery where inguinal hernia occur on both sides of the body or in recurrent inguinal hernia after a previous repair. Patients with inguinal hernia on one side of the body should also consider a laparoscopy hernia surgery as it has significant advantages such as less post-operative pain, earlier return to normal life and lower incidence of chronic pain.

Laparoscopy surgery, often referred to as “keyhole” surgery, is a method of carrying out an operation without having to make a large incision. Small cuts (between 5mm - 10 mm) are made in the patient‘s abdomen through which special viewing and surgical instruments are passed through to perform the surgery. Compared to conventional surgery, patients who undergo laparoscopy surgery can have reduced hospital stays, less post-operative pain and side-effects, and better cosmetic results.

Under a general anesthesia, three small incisions, measuring 5mm and 10mm are made in the abdominal wall. A balloon device is inflated to separate the peritoneum from the muscle layer. The space is inflated with carbon dioxide gas and a telescope inserted into the space. The abdominal cavity is not entered during this procedure, therefore greatly reducing the likelihood of damage to the abdominal organs.

The muscle defect is revealed and the sac of the inguinal hernia is pulled back into this space. A piece of flexible mesh is then slid down the large port and maneuvered so as to cover the hole in the muscle and also all other potential areas where inguinal hernia can occur in this area. The positive pressure in the abdominal cavity pushes the peritoneum onto the mesh trapping it. As the repair is tension free, it is less painful than sutured techniques.

The entire inguinal hernia surgery usually does not take more than 45 minutes and the patient is discharged on the same day with oral pain relief.