Hernia repair is a common surgery conducted through either a conventional open method or using a small telescope known as a laparoscope. The method of conducting a hernia repair with a laparoscope is similar to other laparoscopic surgery. Let’s get an overview of hernia and how a laparoscopic hernia surgery is conducted.
Overview About Hernia
A hernia is a bulge or a tear in a patient’s body that is caused as a result of the weakening of inside layers of abdominal muscle. Commonly, hernias occur in regions like the groin (inguinal) or belly button (umbilical). Hernias can cause a lot of discomforts and a pain that is sharp and sudden that can get worse at the end of the day. The patient must contact the surgeon immediately if he/she suffers from severe and continuous pain, redness, tenderness and if the bulge used to come and go earlier, but now is stuck out.
How is Laparoscopic Hernia Surgery Conducted?
- In a laparoscopic inguinal hernia repair, a surgeon uses an instrument called a laparoscope.
- The surgeon makes two to four small incisions via the abdominal wall to pass the laparoscope (a very thin telescope with a light at the end) and surgical instruments into the stomach.
- The hernia can be viewed from the inside of the abdomen.
- In the next step of the surgery, the abdominal cavity is inflated with carbon dioxide gas so that the surgeon can get the space to work inside the patient, while the actual operating is done remotely with long instruments.
- Further on, the hernia defect is covered with mesh from within the abdomen, and staples are usually fired through it into the muscle tissue to fix it as a patch.
- This minimally invasive surgery is conducted under general anesthesia by making several small incisions in the lower abdomen.
How should a patient prepare for a laparoscopic hernia repair?
- Before the surgery, preparations include blood work, medical evaluation, and an ECG depending on the patient’s age and medical condition.
- After the surgeon reviews the possible risks and advantages of the laparoscopic hernia repair, the patient will be required to give written consent for surgery.
- It is advised that the patient showers the night before or morning of the surgery with an antibiotic soap.
- The night before the operation (after midnight), the patient must not eat or drink anything except medications that the surgeon has said are permissible.
- Drugs like aspirin, blood thinners, anti-inflammatory medications (arthritis medications), and Vitamin-E may need to be stopped for several days to a week prior to surgery. The surgeon provides all the instructions regarding the medications around the time of surgery.
- The patient must quit smoking as it may increase the risk of the hernia recurrence after surgery.
What should one expect after surgery?
- After the surgery, the patient is transferred to the recovery room and will be monitored for 1-2 hours until he/she is fully awake.
- After the patient is awake and can walk, drink liquids, and urinate, he/she can go home.
- In any type of hernia surgery, patients can expect some soreness generally during the first 24 to 48 hours after surgery.
- After a laparoscopic hernia repair, the patient will generally be able to get back to his/her routine activities within a span of a week. Routine activities include showering, driving, walking up and down the stairs, lifting weights, working, and engaging in sexual intercourse.
- The patient must call and schedule a follow-up appointment within 2 weeks after the surgery.
Why Should One Get a Laparoscopic Hernia Surgery?
Laparoscopic surgery is conducted by extensively skilled and trained hernia specialists. Advantages of laparoscopic hernia surgery are:
- There is minimal risk of infection as the incisions are very small
- Laparoscopic surgery employs a small camera where the surgeon gets a clear view of the internal organs which allows him/her to work with incredible skill and efficiency.
- Brief hospital and recovery time
- Pain after the surgery is very less
- The procedure leaves no scar after surgery: Patients who choose to get a laparoscopic surgery done can avoid long surgical scar which is cosmetically unappealing. It leaves lesser scars as smaller incisions heal faster and are less painful.
- Unlike open surgery, in laparoscopy, if the patient has a hernia on the other side too, it can be treated using the same incisions.
Laparoscopic hernia surgery can be inappropriate for patients who:
- Have an incarcerated hernia.
- Cannot endure general anesthesia.
- Have bleeding disorders like hemophilia or immune thrombocytopenic purpura (ITP).
- Are on a medicine (called a blood thinner) that stops blood clots.
- Have had many abdominal surgeries in the past as scar tissue may make the surgery harder to do via a laparoscope.
- Have acute lung diseases like emphysema as the carbon dioxide utilized to inflate the abdomen may affect their breathing.
- Are pregnant.
- Are extremely obese.
Dr. Rengan and his team are highly experienced in the field of laparoscopic surgery for hernia. Choosing the right hernia surgeon for your hernia surgery is important.