Laparoscopic inguinal hernia repair

Laparoscopic hernia repair is similar to other laparoscopic procedures. General anesthesia is given, and a small cut (incision) is made in or just below the navel. The belly is inflated with air so that the surgeon can see the organs in the belly.

A thin, lighted scope called a laparoscope is inserted through the incision. The tools to repair the hernia are inserted through other small incisions in the lower belly. Mesh may be placed over the defect to reinforce the belly wall. Or the edges of healthy tissue may be sewn together.

There are many things to think about when deciding if you should have inguinal hernia repair surgery. For example, is your hernia is incarcerated or strangulated? And do you have other conditions that need to be addressed before hernia repair surgery is needed?

Surgical repair is recommended for inguinal hernias that are causing pain or other symptoms. It's also recommended for hernias that are incarcerated or strangulated. Surgery is always recommended for inguinal hernias in children.

Laparoscopic surgery repair may not be right for people who:

• Have an incarcerated hernia.
• Cannot tolerate general anesthesia.
• Have bleeding disorders such as hemophilia or immune thrombocytopenic purpura (ITP).
• Are taking a medicine (called a blood thinner) that prevents blood clots.
• Have had many belly surgeries. Scar tissue may make the surgery harder to do through the laparoscope.
• Have severe lung diseases such as emphysema. The carbon dioxide used to inflate the belly may interfere with their breathing.
• Are pregnant.
• Are extremely obese.

Laparoscopic hernia repair usually is not done on children. But a laparoscope may be used during open hernia repairs in children to explore the opposite groin for a hernia. This can be done by inserting the scope into the side that is being operated on and looking at the opposite side. If a hernia is seen, the surgeon can repair both sides during the same operation.

Laparoscopic surgery for inguinal hernia repair is safe. The chance of a hernia coming back is low when the repair is done by an experienced surgeon who uses mesh patches. Synthetic patches are now widely used for hernia repair in both open and laparoscopic surgery. The chance that a hernia needs more than one repair also depends on your age and overall health.

Laparoscopic surgery has the following advantages over open hernia repair:

• Some people may prefer laparoscopic hernia repair because it causes less pain and they are able to return to work sooner than they would after open repair surgery.
• Repair of a recurrent hernia often is easier using laparoscopic techniques than using open surgery.
• It is possible to check for and repair a second hernia on the opposite side at the time of the operation.
• Because smaller incisions are used, laparoscopy may be more appealing for cosmetic reasons.