Laparoscopic Inguinal Hernia Repair: Procedure, Benefits & More

When you hear the term “hernia”, you may imagine an uncomfortable and painful-looking bulge in the lower abdomen, right? Well that is only one of the several types of hernia, and is called an inguinal hernia. 

An inguinal hernia is the most common type of hernia which develops in the area of the abdomen close to the groin. Most individuals who develop inguinal hernias need surgery to repair the hernia. Today, laparoscopic inguinal hernia repair is the most popular surgical procedure used to treat an inguinal hernia.

Let’s find out more about inguinal hernia and laparoscopic inguinal hernia repair in this article.

An inguinal hernia is a medical condition that occurs when a portion of the intestine or other abdominal contents protrudes through a weak point or tear in the lower abdominal wall, creating a bulge or lump in the groin or scrotum. 

There are two passages in the lower abdominal wall, one placed on each side of the groin. These passages are called inguinal canals. Since the hernia develops due to protrusion of the abdominal contents through these canals, it is known as an inguinal hernia. 

It is believed that one of the leading causes of an inguinal hernia is weakness in the muscles and connective tissue of the lower abdominal region. An inguinal hernia could develop over time due to additional pressure. Risk factors such as genetics, old age, premature birth, chronic cough, chronic constipation, and activities that increase pressure inside the abdomen, such as heavy lifting, standing, or walking for long hours each day may contribute to the development of an inguinal hernia.

There are two types of inguinal hernia:

• Indirect Inguinal Hernia: This type of hernia is related to a defect in the lower abdominal wall, specifically the inguinal canals, which is present at birth. Even though the defect is present at birth, an indirect inguinal hernia may not occur until years later.
• Direct Inguinal Hernia: In this type of hernia, the weakness in the inguinal canal wall develops later in life. This type of hernia primarily occurs in men and rarely affects women and children.

The main symptom of an inguinal hernia is a bulge in the groin area. In males, it appears as a bulge in the scrotum and can lead to pain, discomfort, heaviness, and burning in the groin area.

In most cases of inguinal hernia, surgery is the most suitable option for repair and treatment. 

To treat an inguinal hernia, there are two types of surgical methods employed:

• Open inguinal hernia repair surgery: It is an invasive technique. In the groin region, a doctor makes one large incision on the skin. The surgeon pushes the hernia back into place, places a piece of mesh to reinforce the abdominal wall, and closes the incisions with stitches. 
• Laparoscopic inguinal hernia repair surgery: Laparoscopic surgery is minimally invasive, with reduced pain, and a faster recovery time. Here only 2 to 4 small incisions are made and a thin scope with a tiny camera is inserted through one of them. This device provides a real-time view of the internal structures. Surgical instruments are inserted through the other incisions in order to repair the hernia. Usually, a piece of mesh is employed to close and strengthen the abdominal wall. Once the procedure is completed, the incisions are closed with sutures.

Let’s find out more about laparoscopic inguinal hernia repair.

Laparoscopic inguinal hernia repair is a minimally invasive surgical procedure to treat inguinal hernias. As the name suggests, it is a laparoscopic procedure, so it employs a laparoscope, a long, thin tube with a camera and light source at one end.

The surgeon makes 2 to 4 small incisions on the abdomen and inserts a laparoscope through one of the incisions. This way, the surgeon is able to visualize the hernia on a monitor. Special surgical tools are inserted through the other small incisions. The herniated portion of the abdomen is pulled back into place, and a piece of mesh is used to close and strengthen the abdominal wall.

There are 2 types of laparoscopic inguinal hernia repair techniques:

• Transabdominal Preperitoneal (TAPP) Surgery: During this surgery, instruments are inserted through the muscle wall of the abdomen and the lining covering the organs (the peritoneum). A flap of the peritoneum is peeled back over the hernia and the abdominal wall is strengthened by stapling or gluing a piece to the weakened area.
• Totally Extraperitoneal (TEP) Surgery: This is the most advanced form of laparoscopic inguinal hernia surgery technique. It involves repairing the hernia without entering the peritoneal cavity. In this surgery also, the incisions are sealed with stitches or glue.

What Happens Before the Surgery? 

• Before scheduling the surgery, discuss the procedure in detail with your doctor. Talk about your expectations and the benefits and risks associated with the surgery. Get all your doubts and queries cleared by the surgeon beforehand.
• Your doctor will discuss your medical history, which includes your symptoms, other present ailments, current medications, and supplements if you are taking any.
• You might be asked to stop certain medications, such as blood thinners, for a brief period before and after the procedure in order to avoid complications such as bleeding.
• Make sure you inform your doctor about any allergies, such as allergies to latex or any medications.
• The doctor will advise you to maintain a healthy weight before you undergo the surgery. Being overweight or obese places you at a higher risk of developing complications.
• If you are a smoker, it is advisable to quit smoking for a certain period before and after the surgery, as it can delay healing. 
• Make sure you arrange for a friend or a family member to help drive you home on the day of surgery and during your recovery.

What Happens During the Surgery? 

• You will be sent to the operating room and given a surgical gown to wear. 
• You will lie on an operating table, and anesthesia will be administered. You will be given general anesthesia. This will put you to sleep and make the procedure painless.
• Your lower abdomen and groin area will be cleaned with an antiseptic solution.
• To provide the surgeon with a clear view, the abdominal cavity is inflated with carbon dioxide gas. The surgery is done remotely using a laparoscope and other surgical instruments.
• Your doctor will make 2-4 small incisions of a small keyhole size in the abdominal region, below the navel area. 
• Your doctor will insert a laparoscope through the incision. The laparoscope transmits images of the internal organs to a monitor and guides the surgeon to the hernia. 
• Now, the surgeon may insert surgical instruments through the other incisions. 
• The surgeon now pushes the protruding abdominal tissue back to its normal position with the help of surgical instruments and also repairs the weakened portion of the muscle wall.
• A synthetic mesh may also be placed in the muscle wall to improve its strength and prevent recurrence. Alternatively, the edges of healthy tissue may be sewn together.
• Finally, the incision is closed with the help of sutures and a sterile dressing.

What Happens After the Procedure? 

• Laparoscopic inguinal hernia repair surgery is an outpatient procedure; so you can go back home on the same day. 
• In rare cases, if the doctor suspects any complication for which further treatment is required, you may be asked to stay back in the hospital for a couple more days.
• After the surgery, you will be sent to a recovery room and your vitals will be monitored as you wake up from the anesthesia. 
• Once the surgical team is satisfied that you are stable, you will be sent home with prescribed medications and post-surgery care instructions. 
• You may experience some pain and discomfort in the area for about 2 weeks post-surgery, which is normal. However, this can be managed with the prescribed medications.
• You should be able to go back to work and your daily routine in 1 to 2 weeks after the surgery. 
• Make sure you get adequate rest and avoid any strenuous activities, such as heavy lifting, for the initial 4 weeks after the surgery. 
• Ensure not to wet the surgical site until it heals well, and keep the area clean and dry. 
• Have a healthy, fiber-rich diet and drink plenty of fluids in order to prevent constipation and avoid any associated complications.
• Follow all the post-surgical instructions given by your surgeon and attend the follow-up visits as instructed in order to achieve a fast and smooth recovery. 

Laparoscopic inguinal hernia repair has the following benefits from traditional hernia repair surgery:

• Reduced pain 
• Faster recovery and return to routine life
• Smaller incisions ensure more cosmetically pleasing results
• Possibility of checking for and repairing a second hernia on the opposite side at the time of the surgery

The following are the major risks associated with laparoscopic inguinal hernia repair:

• Bleeding or infection 
• Neurovascular injury
• Injuries to the surrounding organs
• Testicular complications
• Infection due to the mesh 
• Blood or fluid collection at the hernia site
• Inability to urinate
• Bladder injury
• Scar tissue formation

Surgery can be a daunting aspect, and feeling anxious is absolutely normal. The massive amount of information you can get from the internet may confuse you even more. This is where Medfin can help. Leave us the hefty task of finding the best hospital, the finest doctor, and the latest procedure at the lowest cost. Let us take charge while you sit back and focus on your health and recovery. Think surgery! Think Medfin!