Many hernias can be repaired using a keyhole or laparoscopic hernia surgery technique.
Laparoscopic Hernia Surgery allows for a faster recovery with less discomfort. Our surgeons use small incisions in the abdominal wall to introduce a long thin camera (laparoscope) and instruments to repair a hernia using mesh. Gas is gently insufflated to separate the tissues which gives a view the hernia from the inside (by looking at a television monitor that is attached to the camera).
Other small incisions are made to allow long thin miniature working instruments to be passed to the area of the hernia allowing the surgeon to repair the hernia form the inside. A small piece of surgical mesh is placed over the hernia defect and held in place with small surgical staples. The mesh remains inside the body permanently to reinforce the weak area. Once the operation is completed, the gas is allowed to escape before the cuts are stitched together. This operation is usually performed with general anaesthesia.
Many patients find that this approach gives rise to less pain and therefore enables a faster return to work and normal activities.
What are the pros and cons of open versus laparoscopic hernia repair?
Compared with traditional hernia surgery, laparoscopic repair may result in less discomfort following surgery and a quicker return to normal activities. It is particularly suited in the following situations
- Recurrent hernia. The procedure is a good choice for people who have already had traditional hernia surgery, because laparoscopic methods allow surgeons to work away from the scar tissue from the previous repair.
- Hernias on both sides of the abdomen (bilateral hernias). Rather than making two separate incisions — one over each hernia — both hernias can be repaired with the same 3 small incisions to insert the laparoscopic instruments.
- Requirement to work/exercise quickly. Laparoscopic repair usually requires less recovery time, so you can resume your regular activities more quickly.
- The chance of developing another hernia is low — about 1 % after a laparoscopic procedure if the surgeon uses synthetic mesh to reinforce the repair. This is similar to the recurrence rate after traditional hernia repair using mesh reinforcement.
- In addition, laparoscopic surgery is may take a few minutes longer to perform. It also may carry a slightly greater risk of injury to blood vessels, nerves, bowel and bladder, but these complications are rare.
- As with open repairs, laparoscopic hernia surgery can cause temporary urinary retention — the inability to urinate — although this usually resolves spontaneously within hours.
Is everyone suitable for laparoscopic hernia repair?
Only after a thorough examination can your surgeon determine whether laparoscopic hernia repair is right for you. The procedure may not be best for some patients who have had previous abdominal surgery or underlying medical conditions.
Although laparoscopic surgery has its advantages, it’s not for everyone.
Laparoscopic hernia repair may not be appropriate if:
- You have a large or incarcerated hernia
- You’ve had previous pelvic surgery such as a prostatectomy
- You can’t tolerate general anaesthesia
What are the risks with laparoscopic hernia repair?
All surgery has some risks and complications do occasionally occur: Most complications are mild and easily resolved. Specific risks of Laparoscopic Hernia Repair are:
- In approximately 5 in 100 cases the keyhole method does not work and the surgeon may have to convert to a traditional “open” hernia repair
- There is a small risk that the instruments used in keyhole surgery may cause damage to large blood vessels, the bladder or the intestines. This may require further surgery to repair the damage
- Rarely, damage may occur to the testicular vessels, leading to swelling, pain or shrinkage of the affected testis
- There is a chance (up to 5 in 100) that the hernia may come back, requiring further surgery
- Occasionally, damage to the nerves or tissue during hernia repair may cause long term pain or numbness. This may require further investigation or treatment.
- There may be extensive swelling and bruising of the testicles, scrotum and penis
- Occasionally, some blood or fluid can build up in the groin after surgery and make the area swell and feel tender. Whilst this swelling will often settle, sometimes you may need another small operation to stop it
- Difficulty in passing urine shortly after surgery may occur, requiring the temporary insertion of a catheter to empty the bladder
- A hernia may develop around one of the wound sites. This may require corrective surgery
- Testicular pain is not uncommon but usually only lasts for a short period after surgery
Can I undergo laparoscopic repair of my hernia at the Scottish Hernia Centre?
Yes. Richard Molloy is an experienced hernia surgeon who undertakes both open and laparoscopic hernia surgery at the Scottish Hernia Centre, based at Ross Hall hospital. Ross Hall hospital is Glasgow and Scotland’s premier private hospital, providing state of the art facilities to mange even the most complex hernia problem.
At the initial consultation, your hernia and any other medical problems will be assessed before discussing the surgical options for repair. Details about how to make an appointment are on our Contact Page.
We work with all the major insurers. If you do not have healthcare insurance, we offer competitive fixed price packages which ensure all your costs are covered. Please see our Prices & Payment page for more information.