Hernia Surgery
With Excellent Results
Lap hernia repair
Laparoscopic Hernia Surgery Repair Cases – Inguinal
For recurrent inguinal hernia patients, bilateral inguinal hernia patients, or in women, laparoscopic repair has a definite advantage compared to open repair in terms of recurrence risk, pain, and convalescence. For unilateral primary hernias, either open repair with mesh or laparoscopic repair can provide
Several studies have established laparoscopic inguinal hernia repair to be superior to traditional repair in the following ways
- Decreased postoperative pain
- Decreased need for narcotics
- Sooner return to work
Laparoscopic inguinal herniorrhaphy may be used to describe any of the following three methods:
- extraperitoneal (TEP) repair
- Transabdominal preperitoneal (TAPP) repair
Laparoscopic Hernia Surgery Repair – Ventral/Incisional
The laparoscopic technique provides the surgeon with a clear and definite delineation of the margins of the hernia defect. It detects other defects that were not clinically evident in the preoperative period. Facilitation of visualization of the fascia beneath the old incision enables the detection of more minor ‘Swiss cheese’ defects that might be omitted in an open procedure.
One of the significant factors for a high rate of recurrence after traditional repairs is the phenomenon of occult hernias. These hernias are likely to be overlooked in an open repair. The occult hernia can either be in connection with the original or at some distance from the original hernia but within the prior scar or can be a hernia entirely unrelated to the preceding scar. The benefit of laparoscopic management is that not just the primary hernia but the whole scar and not just the scar but the entire abdominal wall can be explored. Such a method makes sure that occult hernias are identified and treated.
Lastly, a significant overlap of the defect with mesh would prevent displacement of the mesh into the defect by intra-abdominal pressures. The laparoscopic method facilitates using a more oversized prosthesis with adequate overlaps more easily. In the open method, obtaining an overlap of 3 to 5 cm involves extensive soft tissue dissection, leading to increased wound complications. The benefit is more pronounced in obese and large defect patients
Pre aponeurotic endoscopic repair for rectus diastasis
Lastly, a significant overlap of the defect with mesh would prevent displacement of the mesh into the defect by intra-abdominal pressures. The laparoscopic method facilitates using a more oversized prosthesis with adequate overlaps more easily. In the open method, obtaining an overlap of 3 to 5 cm involves extensive soft tissue dissection, leading to increased wound complications. The benefit is more pronounced in obese and large defect patients Abdominal diastasis recti is a common clinical finding; it is diagnosed when there is an abnormal distance between the muscles, ideally more than 2 centimeters, with a common association with an umbilical hernia.
Repairing these defects is a surgical challenge since there is no agreement on which technique to employ, more frequently by abdominoplasty or mini abdominoplasty with periumbilical incision or inverted T approach. The minimally invasive pre-aponeurotic endoscopic repair method shows fewer complications and improved aesthetic outcomes, so the method can be a very good choice for this disease.
