Minimally invasive hernia repair

A hernia occurs when the muscles of the abdomen become weak because of a natural flaw in the abdominal wall or through excessive strain caused by heavy lifting, significant weight gain, constant coughing, or difficulty with bowel movement or urination.

Part of an organ, usually the intestines, then pushes through the weak spot or tear to form a bulge under the skin. About two-thirds of hernias develop near the groin (inguinal hernia), but they can also appear in the upper thigh (femoral hernia), around the belly button (umbilical hernia), or along a previous incision (incisional hernia). Nearly 700,000 abdominal hernia operations are performed each year in the United States.

Risk factors for developing an inguinal hernia include being male, having a family history of hernias, cystic fibrosis, persistent cough, extra weight, pregnancy, premature birth, previous hernia, or difficulty with bowel movement or urination.

Common symptoms of a hernia are discomfort or pain in the groin area that get worse when bending or lifting, a bulge in the groin or abdomen, nausea and constipation, and a feeling of fullness or dull ache.

Most hernias can be pushed gently back into the abdominal cavity. Applying an ice pack to reduce swelling may help the hernia slide in more easily. However, if the hernia cannot be pushed back through the abdominal wall, surgery may be necessary.

Hernia surgery usually is performed on an outpatient basis, with the procedure itself taking approximately one hour. Hernia repair may be performed either by minimally invasive laparoscopic surgery or traditional open repair.

Following open surgery, the patient may go home a few hours after surgery and resume a normal routine within a few days.

Strenuous activity or exercise is not recommended until four to six weeks after surgery. The benefits of laparoscopic surgery compared to open surgery include three small scars versus one large incision, less pain following surgery, and a recovery time measured in days instead of weeks. The surgeon will determine which method is best suited for the individual patient.

There are two general types of hernia operations, herniorrhaphy and hernioplasty. A herniorrhaphy involves making an incision in the groin and pushing the protruding intestine back into the abdomen. The weakened or torn muscles are then sewn together.

During a hernioplasty, the surgeon inserts a piece of synthetic mesh over the entire inguinal area, covering all potential hernia openings. The mesh is then sewn, clipped or stapled to the peritoneum (inner lining of the abdomen).

Congenital defects that lead to an inguinal hernia cannot be avoided, but certain steps can be taken to reduce strain on abdominal muscles and tissues.

  • Stay within a normal weight range.
  • Eat a high-fiber diet.
  • Lift heavy objects properly.
  • Stop smoking.
  • Exercise regularly.
  • Do not rely on a truss (hernia belt) for support.

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