Laparoscopic Repair of Incisional Hernias
Laparoscopic Repair of Umbilical and Incisional Hernias
There are various types of hernias of the abdominal wall. The most common is the inguinal hernia (more frequent in men).
However, umbilical hernias and incisional hernias are also very common.
An umbilical hernia is the appearance of swelling (painful or painless) in the region of the umbilicus.
An incisional hernia frequently appears at the site of a previous surgical scar after an open procedure. It may be small or large.
In both cases, through defects of the abdominal wall, if these widen, an intra-abdominal organ (most commonly bowel or omentum) may protrude, causing symptoms.
Symptoms of these hernias:
• Swelling in the area (small or large), which varies with increases in intra-abdominal pressure
• Pain that worsens as the day progresses, with athletic activities, persistent coughing, or difficulty in urination
When the pain does not subside, urgent surgical evaluation by a specialist surgeon is required, with the possibility of emergency intervention to avoid progression even to peritonitis.
This condition is called incarcerated umbilical hernia or incarcerated incisional abdominal hernia.
EVERY patient diagnosed with these hernias must undergo surgery—electively, or urgently if incarceration is diagnosed.
The laparoscopic repair of an umbilical hernia or incisional hernia is performed under general anesthesia.
Through three small incisions in the anterior abdominal wall, access is gained to the peritoneal cavity, and adequate working space is created with or without the use of a specialised laparoscopic tool.
The hernia sac is identified, reduced, and a sufficiently large mesh is placed to cover the area where hernias develop.
The mesh is secured with a fixation device or biological glue.
The mesh is completely inert to the body, preventing mesh-related complications.
Advantages of this technique:
• Minimal postoperative pain
• Rapid mobilization of the patient with the use of an abdominal binder
• Early resumption of daily activities
• Avoidance of adhesions
SPECIALIZED surgical training is REQUIRED, as well as the availability of specific laparoscopic instruments.
