How is Laparoscopic Hernia Repair Surgery Done?
Surgical treatment
The type of operation depends on umbilical hernia size and location and if it is a repeat hernia (recurrence). Your health, age, and the surgeon’s expertise are also important. An operation is the only treatment for a hernia repair.
Your hernia can be repaired with three surgical procedures: open hernia repair surgery, laparoscopic hernia repair surgery, or robotic hernia repair surgery.
Laparoscopic hernia repair
Laparoscopic (minimally invasive) hernia repair uses a laparoscope, a thin, telescope-like instrument that is inserted through a small incision at the umbilicus (belly button). This procedure is usually performed under general anesthesia, so before the surgery, you will have an evaluation of your general state of health, including a history, physical exam (and possibly lab work) and an electrocardiogram (EKG).
You will not feel pain during this surgery. The laparoscope is connected to a tiny video camera, smaller than a dime, that projects an “inside view” of your body onto television screens in the operating room.
The abdomen is inflated with a harmless gas (carbon dioxide), which creates space to allow your doctor to view your internal structures. The peritoneum (the inner lining of the abdomen) is cut to expose the weakness in the abdominal wall. Mesh is placed on the inside to cover the defects in the abdominal wall and strengthen the tissue.
After the procedure is completed, the small abdominal incisions are closed with a stitch or two or with surgical tape. Within a few months, the incisions are barely visible.
Benefits of laparoscopic hernia surgery include three tiny scars rather than one larger incision, less pain after surgery, a quicker return to work and a shorter recovery time (days instead of weeks).
Open versus laparoscopic hernia repair
There is no significant evidence on the best technique to repair an umbilical hernia, and more study is needed. The type of repair may also depend on the size of the hernia.
- When comparing open mesh repair with laparoscopic mesh repair, there is no difference in the length of hospital stay or recurrence rate. With laparoscopic repair, there is a slightly lower wound complication rate, including seromas, hematomas, and infection. Both types of operations have similar long-term results.
- Open repairs can be done with local anesthesia instead of general anesthesia and are frequently done as outpatient procedures.
- Strangulated hernias may have to be repaired as an open approach.
- The use of mesh provides a stronger repair and decreases the recurrence rate.
- Suture repair will result in a small incision around the hernia site. Laparoscopic repairs usually have 3 to 4 smaller scars at the site of the entry ports.
After the surgery
Most patients will be able to go home a few hours after the open hernia surgery and feel fine within a few days. However, strenuous activity and exercise are restricted for four to six weeks after the surgery.
Benefits and risks of your operation
Benefits – Operation is the only way to repair a hernia. You can return to your normal activities and, in most cases, will not have further discomfort.
Risks of not having an operation—Your hernia may cause pain and increase in size. If your intestine becomes squeezed in the hernia pouch, you will have sudden pain, vomiting and require an immediate operation.
Possible risks include a return of the hernia; infection; injury to the bladder, blood vessels, intestines, or nerves; and continued pain at the hernia site.
Wound care
- Always wash your hands before and after touching near your incision site.
- Do not soak in a bathtub until your stitches, Steri-Strips, or staples are removed. You may take a shower after the second postoperative day unless you are told not to.
- Follow your surgeon’s instructions on when to change your bandages.
- A small amount of drainage from the incision is normal. If the dressing is soaked with blood, call your surgeon.
- If you have Steri-Strips in place, they will fall off in 7 to 10 days.
- If you have a glue-like covering over the incision, allow the glue to flake off on its own.
- Avoid wearing tight or rough clothing. It may rub against your incisions and make it harder for them to heal.
- Protect the new skin, especially from the sun. The sun can burn and cause darker scarring.
- Your scar will heal in about 4 to 6 weeks and will become softer and continue to fade over the next year.
