complex hernia

What is laparoscopy - keyhole surgery?
Laparoscopy or keyhole surgery is a procedure by which organs within a body cavity like inside the abdomen are visualized by inserting a telescope into the cavity through a very small incision. When connecting the telescope to a small video camera the images are transmitted to a video monitor. This image is magnified several times and obtained without physical strain on the patient or the wall of the body cavity.

What is operative laparoscopy or endoscopic surgery?
Since 1990 the principle of laparoscopic keyhole surgery has been applied to chest and abdominal cavity to carry out many major and complex surgical procedures with
minimal organ and tissue handling.

Benefits of laparoscopic surgery compared to open surgery
Laparoscopic surgery has been demonstrated to offer better cosmetic results as incisions are small and become invisible over a short period of time, less pain after surgery, much shorter hospital stay with discharge from hospital the same day or after 1 night. As for recovery, earlier resumption of normal activities and employment. It is not unusual for a manual worker to return to his work within 7 days after keyhole hernia operation or a professional football player to resume training within 7 days and return to a full competitive match within 3 weeks.

Risks & complication of laparoscopic surgery
Laparoscopic surgery carries the same risks as any other surgery with some unique differences. The treating surgeon would discuss those aspects with patient.

  

Potential risks and complications
specific to laparoscopic hernia repair:
- Abdominal wall vessel injury may result in bruising or
. blood collection.
- Hernia recurrence, depending on the type of hernia,
. generally speaking is under 1% if compared with the
. recurrence rate of open hernia repair between 8 and 15%.
- Injury to internal organs, bladder, blood vessels or bowel.
. This is rare.
- Conversion to open surgery is in the order of 1:500 cases
. of hernia repair and would occur if necessary at the same
. setting.
- Anaesthesia for laparoscopic surgery.
- All with general anaesthesia.

  
Risks associated with laparoscopic surgery are:
- Risks associated with general anaesthesia, endotracheal intubation,    drug reaction and cardiac and chest complications.
- Wound infection.
- Bleeding from the entry site.
- Bruising and swelling.
- Blood transfusion may become necessary, but it is rare.
- Hernia recurrence in the case of laparoscopic repair of a hernia or   incisional hernia through the small entry site.
- Keloid and painful scar are rare.
- Blood clots in leg veins, (deep vein thrombosis) and clots in the lungs   are rare.

Surgical Procedures:
Traditional Approach: This surgery is done from the outside through an incision in the area of the hernia. The incision goes through the skin, fat, and allows the surgeon to get to the level of the hernia.

Laparoscopic Hernia Repair:
A laparoscope connected to a camera is inserted through a small hollow tube, allowing the surgeon to view the hernia and surrounding tissue on a video screen. The hernia is repaired from behind the abdominal wall.

Surgical Options:
1. Tissue to tissue repair
2. Flat mesh patch in front of muscle
3. Flat mesh patch behind muscles
4. Mesh patch as a plug
5. Mesh patch as a double disc
6. Flat mesh patch converting to a plug
7. Butterfly Meshª for ventral/incisional hernias

  
     
         

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