Laparoscopic Surgery For Hernias

Overview

What is it? In laparoscopic (key-hole) surgery the operation is carried out through small incisions with the use of a camera instrument which is called laparoscope.

Almost all hernia operations can be performed through a key-hole approach.

The groin region hernias (inguinal hernia, femoral hernia) can be performed with two different techniques, one is called TEP (stands for Total Extra Peritoneal) and the other is TAPP (Trans Abdominal Pre Perioneal). Results of both approaches are very similar.

Most Anterior Abdominal Wall hernias (epigastric, umbilical, ventral, incisional) can also be performed with a laparoscopic approach.

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Keyhole Surgery

Advantages:

– Laparoscopic surgery offers shorter hospital stay and possibly less pain.
– It allows a global view of the anatomy. It allows a smaller incision and offers a better cosmetic outcome.

Disadvantages:
– It requires general anaesthesia
– It is technically more demanding
– The hernia needs to be repaired with a mesh

Treatment

For Groin Hernias
When bilateral (both groins) or when previously operated as open and have subsequently recurred, surgery should preferably be done as a key hole.
When unilateral (one side) or when primary operation was key-hole, surgery should preferably be done as open.

For Anterior Abdominal Wall hernias
For primary repairs, either option is acceptable depending on patient’s preference and the surgeon’s expertise.
For recurrent repairs cases should be assessed on an individual basis