Wednesday, 31 October 2012

Hernia surgery can be a very daunting prospect, but these days the procedure is successfully carried out every day by hernia surgeons all over the world.  An inguinal hernia is the abnormal protrusion of the abdomen contents such as the intestine through an area of weakness in the groin muscles.  The protruding intestine resides in what is known as a hernia sac.  In some cases untreated hernias cause complications, for example, if part of the intestines become stuck in the hernia opening its blood supply may be cut off leading to the death of intestinal tissue, this is called a strangulated hernia.  If a surgeon feels you are at risk of this complication they will likely recommend elective hernia repair surgery.  Traditional open inguinal repair requires a relatively large single incision.  Newer laparoscopic techniques require only tiny keyhole incisions or puncture wounds, which generally result in a shorter recovery period.

The procedure

When you arrive at the hospital an intravenous line will be started and you my be given a sedative to help you relax.  Laparoscopic inguinal hernia repairs are done under general anaesthesia which will put you to sleep for the duration of the operation.  A breathing tube will be temporarily inserted through your mouth into your throat to help you breath during the operation.  A catheter may also be placed in your bladder to drain your urine.  These will be removed at the end of the procedure.

An uncomplicated laparoscospic inguinal hernia repair usually takes between thirty and sixty minutes depending on your situation and your hernia surgeons experience he or she will choose one of two types of laparoscopic approaches, extra peritoneal laparoscopic repair or trans-abdominal preperitoneal repair.  To gain access to the hernia your surgeon will use sharp instruments called trocars to creates three small holes or ports through your abdominal wall.  The location of these ports will vary depending on your hernia surgeons preference and e type of procedure.  One of these ports is usually located at your navel or umbilicus.  Carbon dioxide gas will then be pumped through the umbilical port to 'puff up' your abdomen so it's contents can be viewed more easily.

Next your hernia surgeon will insert the laparoscope through the umbilical port and images from its camera are projected onto a video monitor in the operating room.  Your surgeon will then pass various instruments through the other ports.  These will be used to dissect away the hernia sac and to attach a piece of mesh over the hernia opening to prevent the intestine slipping back through the opening.  Before removing the laparoscope your surgeon will take one final look around for areas of bleeding or other damage.  A port now is briefly left in place to allow all the carbon dioxide to escape abdomen.  Finally the keyhole incisions are closed with sutures or staples and covered with bandages.

After the surgery your breathing tube and catheter will be removed and you will be taken to the recovery area for monitoring.  You'll be given pain medication as needed.  When you are able to drink liquids your intravenous line will be removed.  Most patients can leave the hospital three to five hours after the procedure.