Laparoscopic Inguinal Hernia Repair

Overview

 

UW Health surgeons at UW Hospital and Clinics perform laparoscopic inguinal hernia repair, a procedure which corrects the protrusion of the bowel in the inguinal canal (an abdominal passage to the groin) through the laparoscopic placement of a synthetic mesh to reinforce the weakened area.

 

An inguinal hernia occurs when a small portion of the bowel, the tissue lining of the abdomen, and possibly a loop of intestine bulges out through the inguinal canal. The bulge may be visible in a male's scrotum or near a female's labium majus.

 

There are two separate types of inguinal hernias: direct and indirect. A direct inguinal hernia occurs when a weakness develops in the lower abdominal muscles, often sustained from lifting heavy objects, coughing and straining. Additionally, a direct inguinal hernia can result from pregnancy, obesity or constipation. An indirect inguinal hernia is the most common type of hernia and develops when the inguinal canal fails to close during prenatal development. This type of hernia is most prevalent in males.

 

Although in many cases surgery is not necessary to repair an inguinal hernia, surgical treatment is recommended for incarcerated hernias (when the intestine is trapped in the inaugural canal and cannot be pushed back) and strangulated hernias (when the incarcerated hernia cuts off blood supply to a portion of the intestine).

 

The Procedure

 

In preparation for the procedure, patients are advised to take stool softeners the day before surgery, which they will continue to take after the surgery. Once in the operating room, patients are placed under general anesthesia. In traditional open surgery, a single long incision is made in the groin through which the surgeon operates. Laparoscopic inguinal hernia repair is a minimally invasive approach which only requires a few small incisions, one in or just below the navel for the laparoscope itself and other incisions in the lower abdomen for the other surgical instruments. The procedure repairs the opening in the inguinal canal by placing a synthetic mesh on the defect in order to strengthen the area.

 

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 exercise 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.
  • A laparoscope is capable of viewing both groin areas and everything surrounding 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.