Hernia Surgery
More About Laparoscopy
Laparoscopy is a means of vision. Rather than making a large incision and looking directly into the tissues or abdomen, we make small incisions of 5 (about 1/5 of inch) to 12 mm (about 1/2 inch) and use a telescope to see inside them. Three incisions are used for an incisional hernia repair: two are 5 mm in length and one is 12 mm in length. The scope is attached to a camera that lets us operate while watching on a television screen. We then look into the abdomen and work on the hernia repair from that view, the transabdominal laparoscopic approach.
Remember that a hernia is a hole in the abdomen wall through the muscle layers. Therefore, we can either work on it from the abdominal side, such as in a laparoscopic approach, or through the skin, as in a traditional, open approach. The actual operation is done the same way, but instead of using a 4 to 6 inch incision as in open surgery, we use smaller incisions in laparoscopic surgery. Once the hernia is identified, we divide tissue necessary to get to strong healthy tissue. We then place a large piece of nylon mesh over it and staple it to strong healthy tissue.
How long laparoscopic hernia surgery take?
Usually the operation takes from 30 minutes to two hours depending on the size of the hernia. It is generally true that the smaller the incisional hernia the more rapid the procedure. However, incisional hernia repairs can be long, difficult procedures when intestine is trapped in the hernia space or when scar tissue has accumulated on the intestine from a previous operation. These situations often make it necessary to covert the operation from the laparoscopic approach to an open one.
Does the patient go home the same day?
Yes. Just like the open approach, patients are discharged a few hours after the operation if they had a small hernia and the operation did not require much manipulation of intestine or elimination of scar tissue.
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