Laparoscopic Incisional and Ventral Hernia Repair
UW Health surgeons at UW Hospital and Clinics in Madison, Wisconsin, perform laparoscopic incisional hernia repair, a procedure which corrects the protrusion of the bowel which occurs at the site of a prior surgical incision in the abdomen. The surgery mends the protrusion through the laparoscopic placement of a synthetic mesh to reinforce the weakened area.
An incisional hernia occurs when a small portion of the bowel, tissue lining of the abdomen, and possibly a loop of intestine bulges out through a weakened point in the abdominal muscles due to a previous surgical procedure. The weakening may occur as a result of tension in the muscles when the incision was initially sutured together, or due to improper healing and the prevalence of scar tissue. The bulge may be outwardly visible.
This type of hernia is more likely to develop in patients who are:
- Have had multiple surgeries through the same incision
- Have had previous infections of their surgical wounds
- Users of steroid medications
- Have experienced post-operative lung complications
Once in the operating room, patients are placed under general anesthesia. In traditional open surgery, a single long incision is made near the site of the hernia and the surgeon operates through this opening. Laparoscopic incisional hernia repair is a minimally invasive approach which only requires 2-3 small incisions, one for the laparoscope itself and other incision(s) for the other surgical instruments. First, excess fat and scar tissue is removed from the site of the hernia. Then a synthetic mesh is placed on the areas of weakness in the abdominal muscles in order to reinforce them.
The Difference of Minimally Invasive
There are numerous benefits to having this procedure performed laparoscopically rather than with the traditional open method:
- Faster recovery, patient may return home the same day as surgery, engage in light activities as soon as one to two weeks, and return to strenuous excise as soon as four weeks after surgery
- Less pain post-operatively
- Fewer post-operative complications
- Cosmetic appeal, rather than one long incision across the groin, small barely visible incisions are placed in or below the navel and on the sides of the abdomen.
- Smaller incisions are more ideal for already weakened abdominal tissue. Large incisions can further weaken the abdominal tissue, increasing the risk of recurrence.
- A laparoscope is capable of viewing both groin areas and everything surrounds the hernia. Therefore, the surgeon is able to examine all sites of weakness and reinforce all of them with synthetic mesh, which will help prevent a reoccurring hernia.
- A laparoscopic approach can repair two hernias in one operation if necessary. If a second hernia is discovered with the laparoscope, it can also be repair without making additional incisions. Alternatively, traditional open surgery would require a second long incision to repair a hernia on the opposite side.