Laparoscopic inguinal hernia repair

Background

In early 1990s there was a breakthrough in general surgery. The keyhole inguinal hernia surgery (or laparoscopic inguinal hernia repair) was initiated and then popularized. The risk of inguinal hernias’ occurrence is 27% in men, 3% in women. 75% of all abdominal wall hernias are inguinal hernias. Hernia repair belongs to the forefront when it comes to frequently performed operations in the world.

Laparoscopic hernia repair has many advantages. Side effects, such as severe postoperative pain that can be eased only with narcotic or chronic pain that lasts up to 5 years after operation, occur rarely. However, the surgery has disadvantages as well, such as steeper learning curve, higher recurrence increased cost, lengthier operation, and complication rates early in a surgeon’s experience.

Indications

Patients, who are experiencing symptoms should undergo the surgery. The most important ailments that are indications for inguinal hernia laparoscopic surgery are bilateral hernias and recurrent hernias; if the patient need to return to full activities he may also require to undergo the operation. It mainly depends on the patient what kind of repair will be performed, but the diagnosis of a specialist is crucial as well. Due to the increasing knowledge and experience of surgeons in the field of laparoscopic hernia surgery the number of relapses decreases.

Contraindications

It’s crucial for patient to be properly prepared for the laparoscopic hernia surgery. This means that all ailments or medical issues, such as upper respiratory tract infection or diabetes mellitus should be fully addressed before the operation. Some patients, especially those with elevated American Society of Anesthesiologists should undergo thorough precise health examinations and think about the risk-benefit ratio. There are a few contraindications to keyhole inguinal hernia surgery such as previous preperitoneal surgery, lower midline incision, irreducible hernia or intolerance of general anesthesia.

Complication prevention

Complications can be prevented due to precise laparoscopic anatomy of the groin, that is performed during keyhole inguinal hernia surgery. It’s important to pay attention at every stage of the operation. In order to prevent nerve palsy the appropriate positioning and padding should be taken care of. Carefully performed hernia reduction and the vas deferens and cord structures identification can also help to avoid further problems.

Outcomes

There is a risk of complications after surgery, as with any hernia repair. The most frequently occurring complication is seroma, which often disappears without medical intervention. The effects of laparoscopic inguinal hernia surgery unlike open repair are reduced pain after the operation, equivalent recurrence rates and early return to work.