Minimally Invasive (Laparoscopic or key hole) Repair: Longer time of rest (average 6 weeks) after surgery and the chance of the hernia coming back (recurrent hernia) are some of the limitation of open Hernia surgery which led to rapid popularity of Laparoscopic Hernia Surgery all over the world and in India.Laparoscopic Hernia repair using small incisions offers rapid recovery, less pain and quick return to work.
Small (1.5cm) incision is made just below the umbilicus in the skin and two tiny incisions are placed between the umbilicus and the pubic bone.
The abdomen is inflated with harmless gas (carbon di oxide) to create space to operate. The laparoscope with attached camera and special long instruments are inserted through these incisions.
Surgeon performs the procedure watching high resolution images of the patient’s abdomen on the monitor.
Hernia contents are pulled back in rather than pushed in from outside as is done in an ‘open’ operation and defect repaired with mesh from inside.
Following the procedure, the small abdominal incisions are closed with a stitch or two or surgical tap or glue can be applied.
Less post operative pain
Earlier return to work
Shorter hospital stay
Positioning of the mesh on the inside of the defect is mechanically better than when placed on the outside as in the non-keyhole operation
Recurrent hernias are much easier as approached from the inside, where the tissue has not been affected by the first operation
Hernias on both sides can be repaired through the same three holes as opposed to open surgery where separate incision is to be given on other side
Bleeding and infection are uncommon with Laparoscopic Hernia Repair
There is a slight risk of injury to the urinary bladder, the intestines, blood vessels, nerves or the sperm tube going to the testicle
Difficulty urinating after surgery may require catheter into the urinary bladder for as long as one week
Risk of recurrence very rarely
Once patient is awake walk is encouraged
Routine activities like car driving can be resumed one week after keyhole repair and 2 weeks after open repair
Bath can be taken daily if advised
Avoid bending forward frequently
Avoid strenuous work and lifting weight over 5kg, for 2 months
Normal diet and plenty of liquids are advised. Avoid diet which may cause cough and cold.
Slight pain may be experienced during the first 24 to 48 hours. Painkillers are prescribed for first 2 days
Hospital Stay & Rest:
Most patient go home same day of the surgery (day care surgery)
Normal rest at home for 2-3 days
Some swelling around incision and bluish discoloration is normal in groin hernias, which can be up to scrotum
Blood investigations, chest x-ray, ECG and medical evaluation for fitness for anaesthesia.
Eating or drinking and smoking are stopped 6 hours prior to operation.
Drugs such as aspirin, blood thinners, anti-inflammatory medications and Vitamin E are to be stopped a week prior to surgery