Laparoscopic Hernia Repair

Dr Calvin Ong

mbbs M.Med (Surgery) MRCS FRCS

Benefits Types Preparation Procedure Post-Surgical Risks

What is Laparoscopic Hernia Repair?

Laparoscopic hernia repair is a minimally invasive surgical procedure used to correct hernias, which occur when an organ or tissue protrudes through a weak spot in the abdominal wall muscle.

A laparoscope, a thin tube with a camera and light inserted through small incisions in the abdomen, allows the surgeon to view and repair the hernia using specialised instruments. Laparoscopic repair offers advantages over traditional open surgery, including smaller incisions, reduced pain, and faster recovery.

Benefits of Laparoscopic Hernia Repair

Laparoscopic hernia repair has several advantages over traditional open surgery, including:

Smaller Incisions

Laparoscopic surgery involves small incisions compared to the larger incision required for open surgery. This results in reduced scarring, a lower risk of infection, and less trauma to the body, which contributes to a quicker and more comfortable recovery.

Less Pain

The minimally invasive nature of laparoscopic surgery typically results in less postoperative pain than open surgery. This can make recovery more manageable and reduce the need for pain medication.

Faster Recovery

Laparoscopic hernia repair generally leads to shorter hospital stays and a quicker return to normal activities compared to open surgery. The procedure’s minimally invasive nature allows for faster healing and less disruption in daily life.

Reduced Recurrence Rate

The use of synthetic mesh in laparoscopic hernia repair helps reinforce the abdominal wall, reducing the likelihood of the hernia recurring, and offers longer-lasting results.

Smaller, Less Noticeable Scars

The small incisions used in laparoscopic surgery result in smaller, less noticeable scars compared to the larger scar from open surgery. This is a factor for patients who are concerned about the cosmetic appearance of their surgery site.

Types of Hernias Treated with Laparoscopic Surgery

Laparoscopic surgery can treat various types of hernias, including:

Inguinal Hernia

This occurs in the groin area and is more common in men.

Femoral Hernia

This appears just below the groin and is more common in women.

Umbilical Hernia

This occurs near the navel.

Incisional Hernia

This develops at the site of a previous surgical incision.

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Surgery Preparation

A thorough preparation is required before laparoscopic hernia repair. Here are some steps that patients typically follow:

Medical Evaluation

A thorough medical evaluation, including blood tests and imaging studies, is conducted to ensure the patient is fit for surgery.

Medication Review

Inform the surgeon about all medications, supplements, and allergies. Some medications may need to be adjusted or temporarily discontinued.

Fasting

Patients are generally required to fast for several hours before the surgery, usually beginning the night before.

Preoperative Instructions

Follow the specific instructions provided by the surgical team, such as showering with antibacterial soap.

Transportation

Arrange for someone to drive the patient home after the procedure, as the effects of anaesthesia can impair driving ability.

your treatment roadmap

Step-by-Step Procedure

The laparoscopic hernia repair procedure involves several steps:

Anaesthesia

The patient is given general anaesthesia to ensure that they are asleep and pain-free during the surgery.

Incision and Access

Small incisions (typically three) are made in the abdomen. The laparoscope is inserted through one of these incisions.

Inflation

The abdomen is inflated with carbon dioxide gas to create space for the surgeon to see and operate.

Visualisation and Repair

The laparoscope transmits images to a monitor, allowing the surgeon to locate the hernia. Specialised instruments are inserted through the other incisions to push the protruding tissue back into place and reinforce the abdominal wall with a synthetic mesh.

Closure

The instruments and laparoscope are removed, and the small incisions are closed with sutures or surgical tape.

Post-Surgical Care

Effective post-surgical care supports recovery from laparoscopic hernia repair. Some aspects to consider are:

Pain Management

Patients may experience discomfort, which can be managed with prescribed pain medication. Over-the-counter pain relievers may also be recommended.

Activity Restrictions

Patients are advised to avoid strenuous activities and heavy lifting for several weeks. Light activities and walking are encouraged to promote circulation and prevent blood clots.

Wound Care

The incision sites should be kept clean and dry. Patients should follow their doctor’s instructions for wound care and watch for signs of infection, such as redness, swelling, or discharge.

Follow-up Appointments

Regular follow-up appointments with the surgeon are required to monitor healing and address any concerns.

Diet and Hydration

A well-balanced diet and proper hydration can aid in recovery. Patients should initially avoid heavy or greasy foods before gradually returning to their regular diet.

Potential Risks and Complications

While laparoscopic hernia repair is generally safe, there are potential risks and complications. These can be classified as common risks or serious risks.

Common Risks

Common risks are usually minor and can be managed with appropriate medical care. These include:

Infection: Infections can occur at the incision sites, which lead to redness, swelling, and pain. These are typically managed with antibiotics.
Bleeding: Some bleeding may occur during or after the surgery. This is usually minor and can be controlled.
Pain: Some pain and discomfort are common after surgery but usually subside within a few days. Over-the-counter pain relievers can help manage this discomfort.
Recurrence: <5% risk of recurrence of the hernia after surgery.

Dr Calvin Ong Jianming

Senior Consultant, Colorectal & General Surgeon

MBBS (S’pore)|

M.Med (Surgery)|

MRCS (Ireland)|

FRCS (Edin)|

王健名医生

Dr. Calvin Ong is a Senior Consultant with more than 15 years of surgical experience. He specializes in colorectal and general surgery, performing minimally invasive as well as advanced robotic surgeries for benign and malignant colorectal conditions, including inflammatory bowel disease, pelvic floor disorders, colorectal cancer, and hernia repair. He is dedicated to providing high-quality, personalised care for his patients.

Dr. Ong graduated with a Bachelor’s degree in medicine and surgery from the National University of Singapore in 2008 and completed his Masters of Medicine (Surgery) at the same institute. He finished his advanced specialist training in 2016 and became a fellow of the Royal College of Surgeons of Edinburgh.

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