What is a hernia?
A hernia occurs when the abdominal wall weakens (e.g. in the groin) and then bulges or tears. The inner lining of the abdomen then pushes through the weakened area to form a lump, which may move in and out.
Not infrequently, a loop of bowel can get stuck causing a very painful lump to appear - the so-called 'strangulated' hernia, which requires emergency surgery. Hernias usually occur because of a natural weakness in the abdominal wall or from excessive strain on the abdominal wall. Approximately 80% of all hernias are located near the groin (inguinal hernia). Hernias may also be found below the groin (femoral hernia), through the navel (umbilical hernia), and along a previous incision (incisional hernia).
Open (Traditional) Inguinal Hernia Surgery
Surgical repair of a hernia is called a herniorrhaphy. The surgeon will push the bulging part of the intestine back into place and most often will reinforce the defect with a synthetic mesh material. Surgery can be done on a day case basis. The operation usually lasts about 30 mins, and can be done under either local (i.e. with the patient awake) or general anaesthesia. Usually the patient can go home the same day, but should avoid driving for 10 days.
Laparoscopic (Keyhole) Inguinal Hernia Surgery
Laparoscopic hernia repair is performed under general anaesthesia. Unlike open surgery, 3 - 4 tiny cuts are made on the tummy to allow the surgeon to repair the hernia from within using a long thin telescope attached to a camera. The defect is covered with a synthetic mesh material that is anchored securely to the abdominal wall from inside.
What are the advantages of laparoscopic hernia repair?
Patients experience much less postoperative pain, heal faster, and many are able to resume full normal activities in as little as two days (compared to 3 - 4 weeks).
Laparoscopic inguinal hernia operations result in a much lower risk of chronic groin pain than open mesh techniques with very similar recurrence rates. The National Institute for Clinical Excellence has therefore recently revised its guidelines to allow use of this technique for primary unilateral inguinal hernia repairs, and not just bilateral or recurrent inguinal hernias. |