Surgical Procedures:

Laparoscopic Hernia Repair

Hernias have traditionally been repaired by open surgical techniques. The advances of laparoscopic surgery have now enabled us to repair hernias using this method. Dr Fenton-Lee routinely performs laparoscopic hernia repair.

Click to see the advantages of laparoscopic hernia repair here.

What does hernia surgery involve?

Laparoscopic hernia surgery involves admission into hospital, usually the day of surgery and a general anaesthetic.

For groin hernias, three small (5mm) incisions are made in the middle of the abdomen below the belly button. A space is made just below the surface of the abdominal muscles where the hernial sac occurs and this is inflated with carbon dioxide. This allows the surgeon to visualise and repair the hernia.

The laparoscope or thin telescope attached to a video camera, is passed into the space created through ports inserted in the incisions. A laparoscope allows the surgeon to visualise the hernia by viewing on a monitor.

The hernial sac is then identified and reduced back into the abdominal cavity where it originated. Finally, the weakness in the muscle wall that created the hernia is repaired. This is done by placing a fine, plastic mesh over the defect and securing it with special spiral metal clips.

The instruments are then removed and the carbon dioxide used to inflated the cavity released. The incisions are closed with dissolvable sutures and dressings applied.

The operation itself takes about 20-30 minutes to complete.

What complications can occur?

Laparoscopic hernia repair is a common and very safe procedure, but despite the high standards of surgical practise, complications can occur. The possible complications from this surgery include

1. Injury of the bladder which is near the hernia site
2. Injury to nerves when the mesh is attached to the muscle
3. Swelling of the scrotum in men from the gas that is used to inflate the cavity. This is very common, but usually lasts 24-48 hours and requires no treatment.
4. Bleeding/Infection
   Significant bleeding during or following the operation is rare. Post operative infection is also rare. These complications are reduced by the administration of a single dose of antibiotic at the time of operation.
5. Injury Due to Trochar Placement
   To allow the smooth insertion and removal of laparoscopic instruments in and out of the abdominal cavity , short, hollow ports are used. Insertion of these ports is done under vision, but rarely injury to blood vessels or underlying bowel may occur which require repair.
6. Recurrence of hernia - Dr Fenton-Lee's recurrence rates are lower than with traditional open hernia repair techniques.

What will i be like after the operation?

Following the procedure, most patients are comfortable and eating and drinking normally. Mobilisation is encouraged early with the aid of pain medications. Patients are able to return home once they are mobilising independently, pain control is achieved with oral medications and they are tolerating a normal diet. This is generally achieved the following day.

Light activities may commence immediately, most people are back to full activities within two weeks. A post operative appointment is made with Dr Fenton-Lee two weeks following discharge from hospital.

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