Hernia RepairDelivering Quicker Recovery with Less Pain
Herniorrhaphy (Hernioplasty, Hernia repair) is a surgical procedure for correcting hernia. A hernia is a bulging of internal organs or tissues, which protrude through an abnormal opening in the muscle wall. Hernias can occur in the abdomen, groin, and at the site of a previous surgery.
An operation in which the hernia sac is removed without any repair of the inguinal canal is described as a ‘herniotomy’.
When herniotomy is combined with a reinforced repair of the posterior inguinal canal wall with autogenous (patient’s own tissue) or heterogeneous (like steel or prolene mesh) material it is termed Hernioplasty as opposed to herniorrhaphy in which no autogenous or heterogeneous material is used for reinforcement.
In recent years, as in other areas of surgery, laparoscopic repair of inguinal hernia has emerged as an option. “Lap” repairs (sometimes called “keyhole” surgery or minimally invasive surgery) are also tension-free, although the mesh is placed within the pre-peritoneal space behind the defect as opposed to in or over it. Advantages of lap over the open method include a faster recovery time and a lower post-operative pain score.
Like the open method, laparoscopic surgery may involve local or general anesthesia, depending on the size and related factors of the hernia. Lap is usually more expensive as it requires more Operating Room time than open repair, but a shorter hospitalization period.
There is no definitive consensus as to the comparative risk of complications, or comparative rate of recurrence compared to the open tension-free repairs. However, most non-emergent abdominal surgeries are moving to laproscopic methodologies, as the smaller incisions used result in less bleeding, less infection, faster recovery, reduced hospitalization and reduced pain.
One specific method of laparoscopic repair is totally extraperitoneal (TEP) repair. TEp repair has been associated with fewer complications and a significantly shorter duration of post-operative analgesia than Lichtenstein repair for recurrent inguinal hernia.