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What is a Laparoscopic Hernia Repair, and is it the Right Treatment for You?

Posted Jul 11 2011 12:00pm

So you’ve been diagnosed with a hernia , and your physician has recommended you undergo surgical repair before you start experiencing any potentially serious problems which may arise if your hernia is left untreated. Approximately 600,000 people undergo hernia repairs each year in the United States. Most of these are performed using an “open” approach which provides direct external access to the hernia defect through a single skin incision. Recently, an increasing number of patients have been undergoing Laparoscopic Hernia Repairs. This minimally invasive technique of hernia repair offers several advantages for proper candidates. Perhaps you may be an appropriate candidate for a Laparoscopic Hernia Repair.

In the Laparoscopic Hernia Repair three ½-1cm incisions are made in the abdominal wall. A long, thin camera (laparoscope) is inserted through an access tube in one incision and two surgical instruments are placed through the remaining incisions.The camera gives the surgeon an “internal” view of the abdominal wall and the hernia which is displayed on a video screen in the operating room. The hernia defect is then repaired from the inside of the abdominal wall using a piece of surgical mesh .

Compared to the conventional “open” approach, the laparoscopic repair is associated with a faster recovery, with most patients experiencing minimal pain and a quicker return to work and normal activities. The approach is most beneficial for patients with bilateral hernias (both left and right sides), allowing both sides to be fixed at the same time without any additional incisions, and virtually no additional discomfort. Patients with recurrent hernias are also good candidates for laparoscopic repair, since “open” repairs for recurrent hernias are known to have a much higher risk of complications such as re-recurrence, nerve injury, and injury to blood vessels. The smaller incisions used in Laparoscopic Hernia Repairs also result in an exceptional cosmetic result when compared to the open procedure.

However, not everyone is a candidate for a Laparoscopic Hernia Repair. Patients with a history of previous abdominal surgery , prostate surgery, or obesity may not be suitable for a laparoscopic repair as visualization may not be optimal in these situations. In rare cases, a surgery started laparoscopically cannot be completed and the operation must be converted to the “open” procedure.

So are you a candidate for a Laparoscopic Hernia Repair? Only after a detailed consultation and physical examination can your surgeon determine whether Laparoscopic Hernia Repair is right for you. The risks and benefits of each procedure must be weighed, and all patients should be made aware of the possibility of converting a laparoscopic procedure to an open one. The decision to perform or convert to an open procedure is a judgment decision made by your surgeon either before or during the actual operation. When the surgeon feels that it is safest to convert the laparoscopic procedure to an open one, this is not a complication, but rather sound surgical judgment. The decision to convert to an open procedure is strictly based on patient safety.

Incision Sites for Laparoscopic Hernia Repair

Internal view of hernia defect seen with laparoscopy

Placement of mesh over hernia defect

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