Laparoscopic Inguinal Hernia Repair
An inguinal (groin) hernia is a defect in the abdominal wall caused by a weakness in the abdominal muscles. Contents from the abdominal cavity such as fat or intestines can then be pushed through the defect. This results in a bulge in the groin area, and is usually accompanied by pain in the region. Other more serious complications such as intestinal incarceration (trapping of the intestine in the hernia sac) or strangulation (gangrene) of the intestine can also occur. These areas of weakness on the abdominal wall are natural, and there is no way to strengthen these muscles. They can occur at any age, and are commonly seen with heavy straining, injury or aging. Hernias do not close on their own and typically get larger over time. Inguinal hernia repairs are one of the most common surgical procedures performed, with approximately 600,000 repaired in the United States annually.
View of a hernia using a laparoscope Completed repair with mesh covering the hernia
Inguinal hernia repairs have traditionally been performed through an open technique. This technique utilizes up to a 4 to 5 inch incision in the groin, and requires dividing of the muscles underlying the incision in order to perform the repair. There is now the option of having these repairs performed with minimally invasive techniques. This usually involves making 3 incisions on the abdominal wall that are ¼ inch to ½ inch in diameter. The procedure is then performed through these incisions using highly specialized instruments and placement of a mesh material. Both the open and laparoscopic techniques are typically performed as outpatient procedures. While both procedures work well in repairing the hernias, the laparoscopic technique typically offers less pain and scarring, and a more rapid return to work and other activities. The recovery from an open approach can be three to five weeks, and requires at least six weeks of no heavy lifting. The laparoscopic approach typically allows a return to work in less than a week and a much faster return to normal activities. The laparoscopic repair is particularly suited when a patient has a hernia on each side, as this approach will allow both hernias to be repaired during the same procedure and without any extra incisions. Only one side is repaired at a time with the traditional open approach. The laparoscopic repair can be used to treat direct and indirect inguinal hernias (groin hernias), femoral hernias, as well as hernias located in other parts of the abdomen.