A hernia is a
protrusion of a viscous or part of a viscous outside the cavity which normally
contains it. The protrusion is usually through an abnormal opening in the wall
of the containing cavity. A hernia is called irreducible when its contents
cannot be returned to the abdomen and strangulated when the blood supply to the
contents is compromised, with a risk of gangrene.
What
are the various types of hernia?
Hernias can occur in any weak or
torn part of the abdominal wall. An incisional hernia usually
protrudes through the scars of previous surgical incisions and can develop
months to years after the initial surgery. The most common hernias occur in the
groin area. An indirect inguinal hernia descends from the abdomen and can
extend all the way into the scrotum. A direct inguinal hernia occurs less
frequently and is usually caused by an acquired weakness in the groin. A
femoral hernia is more common in women and is the result of an acquired
weakness in the lower groin area.
How
are hernias treated?
When a hernia is diagnosed, surgical
repair is usually recommended because it will not go away by itself and serious
complications can develop.
Howis laparoscopic hernia repair performed?
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Laparoscopic hernia repair is
performed with the patient under general anesthesia. A small, one-half inch
incision is made near the navel and the abdominal wall is elevated by inflating
the abdomen with carbon dioxide gas. A small metal tube is placed through this
incision into the abdomen, which allows the laparoscope (a thin, lighted tube
used to look at tissues and organs inside the abdomen) to be introduced to
identify the hernia. Two more cannulas (hollow sheaths) are then introduced in
the right and left sides of the abdomen. The surgeon uses these cannulas to
introduce the patch and various instruments to perform the surgery.
Once the defect is identified, the
inner lining of the abdomen is prepared to provide a covering for the mesh that
will be used to repair this weakened area from the inside. The defect is
measured, and an appropriate piece of mesh is introduced and stapled into
place.
When
is laparoscopic hernia repair the treatment of choice?
Traditional open surgical repair is
usually the operation of choice for inguinal hernias located on one side that
have not previously been repaired. The laparoscopic approach is most often used
for patients who have recurrent hernias or hernias on both sides of the groin.
The appropriate method is determined after your examination in consultation
with your surgeon.
What
are the advantages of laparoscopic hernia repair?
· Tiny openings, each
1/4 to 1/2 inch in diameter, instead of the traditional 3- to 5-inch incision.
· Much less postoperative
pain
· Faster healing,
resume normal activities in as little as two days compared to 3 to 5 weeks
· In addition, with
laparoscopic hernia repair, the mesh patch used to cover the abdominal defect
is placed on the inside of the abdominal wall instead of the outside.
·
This method works with the natural outward pressure of the abdomen to
secure the repair and promote healing.
