Setup for laparoscopic inguinal hernia
The basic technique for minimally invasive laparoscopic ventral hernia repair is straightforward. Once the patient is asleep under general anesthesia, the abdomen is insufflated (inflated) with carbon dioxide to create a visible working space, known as a pneumoperitoneum. Once this working space is established, small tubes known as trocars are inserted through multiple small skin incisions and then placed across the abdominal wall muscles and into the abdominal cavity. These incisions are either five or ten millimeters in length.
Incision sites for laparoscopic inguinal hernia
A small camera contained within a metal cannula known as a laparoscope is inserted to allow a clear and unobstructed view of the intra-abdominal contents, including the abdominal wall. In this manner, any and all hernia defects can be easily seen. Usually two additional trocars are inserted to allow for the insertion of additional small instruments. These highly specialized instruments allow for careful manipulation of the intestines as well as repair of abdominal wall hernias. Once the hernia is identified, any incarcerated contents (i.e. intestines or fat that are stuck within the hernia sac) are removed (reduced) from within the hernia.
A view from the laparoscopic camera entering the body
The defect can then be sutured closed. A piece of synthetic mesh is then placed and secured to the inside of the abdominal wall in order to reinforce the defect and make the repair much stronger. Mesh reinforcement has been proven to significantly reduce the rate of future hernia recurrence.
The use of advanced laparoscopic techniques allows for repair of very large hernia defects without the need for large incisions. This reduces the likelihood of developing surgical wound complications such as wound infections and/or separations.
