Laparoscopic Hernia Repair

Dr. Sulaiman Bin Yusof

MbChB (Sheffield) M.Med (Surg) FRCSEd (Gen Surg)
蘇萊曼·尤索夫博士

Laparoscopic hernia repair is a minimally invasive surgical technique used to fix hernias. A hernia occurs when an internal organ or tissue protrudes through a weak spot in the muscle or surrounding tissue wall.

This procedure is favoured because it typically results in less postoperative pain, quicker recovery, and smaller scars compared to traditional open surgery. Laparoscopic hernia surgery relieves pain and prevents complications such as hernia strangulation, where the blood supply to the herniated tissue is cut off. The goal is to restore normal anatomy and function to the damaged area, improving the patient’s quality of life.

Indications for Laparoscopic Hernia Repair

Laparoscopic hernia repair is recommended for various types of hernias and patient conditions. The indications include:

Bilateral Inguinal Hernias

These occur in the groin area and are the most common type of hernia in both men and women. Laparoscopic repair is often suggested for patients with bilateral inguinal hernias (hernias on both sides) or recurrent hernias that have recurred after previous surgical repair.

Ventral and Incisional Hernias

Ventral hernias occur in the abdominal wall, while incisional hernias develop at the site of a previous surgical incision. Laparoscopic repair is advantageous for these hernias as it can address multiple areas of weakness through small incisions, reducing the risk of further complications.

Femoral Hernias

These hernias occur just below the groin and are more common in women. Laparoscopic surgery is often preferred due to the difficulty of accessing the femoral canal through open surgery.

High-Risk Patients

Laparoscopic hernia repair may be indicated for patients who are at higher risk for complications with open surgery, such as those with obesity or chronic conditions that affect wound healing. It is also suitable for patients who require a faster return to daily activities due to personal or professional commitments.

Benefits for Laparoscopic Hernia Repair

Laparoscopic hernia repair offers several advantages over traditional open surgery. These benefits are:

Less Postoperative Pain

Laparoscopic hernia repair typically results in less postoperative pain compared to open surgery. The smaller incisions used in laparoscopic techniques cause less trauma to the body’s tissues, leading to a more comfortable recovery for the patient.

Faster Recovery Time

Patients who undergo laparoscopic hernia repair often experience a quicker return to normal activities. The minimally invasive procedure reduces hospital stay and recovery time, allowing patients to return to daily activities sooner.

Smaller Scars

The small incisions used in laparoscopic surgery result in minimal scarring. Laparoscopic surgery leaves tiny, less noticeable scars and is more cosmetically appealing than open surgery.

Detailed Examination

The laparoscope provides a detailed view of the internal structures, allowing your surgeon to examine the abdominal cavity thoroughly. This can help identify and address any additional issues that might not be visible with open surgery, benefiting the patient by ensuring a more thorough treatment.

Lower Risk of Infection

Smaller incisions reduce the risk of wound infections. The accuracy of laparoscopic surgery also minimises exposure of internal tissues to potential contaminants. This lowers the patient’s risk of getting an infection even more.

Step-by-Step Procedure

Here is a step-by-step overview of the laparoscopic hernia repair procedure:

Anaesthesia

The procedure begins with the administration of general anaesthesia, ensuring that the patient is unconscious and pain-free throughout the surgery. The type of anaesthesia used is usually discussed with the patient.

Creating the Incisions

The surgeon will make three to four small incisions in the abdominal wall, each about 0.5 to 1 cm long. These carefully placed incisions are entry points for the laparoscope and surgical tools.

Inserting the Laparoscope

A laparoscope, equipped with a high-definition camera and light source, is inserted through one of the incisions. The camera sends magnified images of the abdominal cavity to a monitor, providing the surgeon with a clear and detailed view of the hernia and surrounding structures.

Insertion of laparoscopic instruments

Specialised laparoscopic tools are inserted through the other incisions. These instruments are long and thin and are used to work on tissues and repair the hernia.

Repairing or Reinforcement of the Hernia

Mesh Placement and Securing (Hernioplasty): A synthetic mesh is introduced through one of the incisions. The mesh is positioned carefully over the weakened area of the muscle wall to provide reinforcement. It is then fixed in place using sutures, tacks, or surgical glue. This reinforcement strengthens the muscle wall and helps prevent the hernia from recurring. The choice of fixation method depends on the specific case and your surgeon’s preference.

Closing the Incisions

Once the hernia is repaired, the tools are removed, and the small incisions are closed with sutures or surgical glue. The incisions are then covered with sterile dressings and typically heal with minimal scarring.

Are Your Hernia Symptoms Affecting Your Quality Of Life?

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Post-Procedure Care and Recovery

Post-procedure care and recovery after laparoscopic hernia repair is needed for a smooth and successful healing process. After the procedure, patients are monitored closely and given pain relief, and many can go home the same day or the next.

In the first week, managing pain, keeping the surgical area clean, and doing light activities like walking are important. Over the next few weeks, patients should gradually return to normal activities but avoid heavy lifting and strenuous exercise. Full recovery may happen as fast as a couple of months.

During this time, patients should still strictly follow their doctor’s advice on necessary diet and lifestyle changes.

Risks of Laparoscopic Hernia Repair

While laparoscopic hernia repair is generally safe and effective, any surgery carries risks and potential complications. The risks can be categorised into common risks and severe complications.

Common Risks

Common risks are typically less serious and can often be managed with standard post-operative care.

Infection

Despite its minimally invasive nature, laparoscopic surgery might cause an incision site or internal infection. Symptoms of infection include redness, swelling, warmth, fever, and discharge from the incision. Most infections can be treated with medications and medical attention.

Minor Bleeding

Though laparoscopic surgery causes less blood loss than open surgery, bleeding can still occur during or after the treatment. Minor bleeding can often be managed with routine post-operative care, but severe bleeding may require additional surgery.

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Dr. Sulaiman Bin Yusof

MbChB (Sheffield)

M.Med (Surgery)

FRCSEd (General Surgery)

蘇萊曼·尤索夫博士

Dr. Sulaiman Yusof is a distinguished Senior Consultant in colorectal and general surgery, boasting over 15 years of expertise. His passion lies in minimally invasive techniques, particularly robotic surgery, where he has achieved remarkable success using the Da Vinci Xi system. Dr. Sulaiman is dedicated to delivering high-quality, personalized, and empathetic care, always striving for the best outcomes for his patients.

Education & Specialist Training
  • MbChB(Sheffield)
  • M.Med(Surgery)
  • FRCSEd(General Surgery)

Dr. Sulaiman’s journey began at the University of Sheffield, where he graduated in 2002. He honed his skills during his house officer and basic surgical training in the UK before returning to Singapore. There, he completed his Advanced Surgical Training at Changi General Hospital and earned the Joint Speciality Fellowship in General Surgery in 2013.

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    Frequently Asked Questions

    How long does laparoscopic hernia repair surgery take?

    The duration of the surgery typically ranges from one to two hours, depending on the complexity of the hernia. This includes the time needed for anaesthesia, repair, and post-operative monitoring before the patient is moved to the recovery room.

    Who is a good candidate for laparoscopic hernia repair?

    Laparoscopic hernia repair is suitable for inguinal, ventral, incisional, and femoral hernias. Patients with obesity or chronic wound-healing disorders who are at risk for open surgery complications can use it. The hernia kind and location, patient health, and surgeon’s expertise determine the decision.

    Will I need a follow-up appointment after the surgery?

    Yes, follow-up appointments are important to monitor the healing process and ensure no complications. The first follow-up appointment is usually scheduled within 1-2 weeks after surgery. Additional visits may be required based on the patient’s recovery and any concerns.

    Is laparoscopic hernia repair suitable for all types of hernias?

    Suitability varies depending on the size and location of the hernia, the patient’s health, and certain other conditions. Your surgeon will assess each case to choose the optimal surgery.

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