Laparoscopic incisional hernia repair surgery is a surgical procedure used to repair an incisional hernia. An incisional hernia is a protrusion or bulge which occurs directly along or near a previous abdominal surgical opening.
Indications for laparoscopic incisional hernia repair surgery
A doctor can recommend laparoscopic ventral incisional hernia repair surgery if he or she notices the following:
- Symptoms like pain and increase in the size of the swelling on walking or any kind of exertion.
- Incarceration risk, especially for hernia pouches with a small neck where the content is bowel.
How is laparoscopic ventral incisional hernia repair surgery performed?
The doctors position the patient flat, with all pressure points padded and the arms tucked. After establishing the pneumo-peritoneum through a 10mm trocar, the surgeon inserts other trocars.
Abdominal wall adhesions must be removed, including any relevant preperitoneal fat to outline the abdominal fascia. Also, the edge of the facial wound is cleared from adherent tissue to allow the placement of a precise stitch.
Applying external pressure can assist the surgeons to invert the hernia sac into the abdomen, thus facilitating its laparoscopic extraction while avoiding injury to the nearby skin. The defect is usually suture closed laparoscopically and an intra-peritoneal mesh is fixed.
Advantages of laparoscopic repair
Laparoscopic incisional hernia repair surgery reduces the overall skin and muscle trauma as well as disability and post-operative pain. Another major benefit of laparoscopic incisional hernia repair is that the patient stays in the hospital for a shorter period and recovers quickly from the surgery. Open surgery cannot offer all these benefits.
Reduced chances of infection is another benefit a patient gets after undergoing laparoscopic incisional hernia repair. Laparoscopic incisional hernia repair provides the surgeon with video magnification, which allows the surgeon to have a better view of the affected area as well as its surrounding nerves and vessels. Because of this, the surgeon can perform delicate maneuvers to avoid harming these organs during the surgery.
Side effects or complications of incisional hernia repair surgery
Long-term complications as a result of laparoscopic incisional hernia repair surgery are infrequent. However, obese patients or patients with multiple previous surgeries or patients with earlier placement of mesh face short-term risks of laparoscopic ventral incisional hernia repair surgery. There are known factors which cause a second incisional hernia, thus warranting a repeat surgery. You should understand that each time surgery is repeated, the higher the risk of complications. Postoperative infections are few with laparoscopic ventral incisional hernia repair surgery compared to open surgery.
Some of the complications which tend to develop after incisional hernia repair surgery include:
- Respiratory problems
- Nerve injuries
- Urinary retention
- Intestinal injury
- Fever, which is usually caused by surgical wound infection
- Intra-abdominal swelling
- Chronic suture pain
- Mild postoperative bleeding
- Fluid buildup where the mesh is placed.
After the surgery, the patient is placed in a recovery room, where the nursing team will observe him or her for some hours. The nursing team usually monitors blood pressure, body temperature, heart function, and pulse. Also, the surgical incisions are observed for unwarranted swelling or bleeding.
Patients who undergo laparoscopic incisional hernia repair surgery are mostly discharged after 2 to 3 days of surgery, while more intricate hernias like strangulated and incarcerated hernias require the patient to be hospitalized for longer. Some patients do experience prolonged pain at the suture pain, which can be treated with anti-inflammatory drugs or pain medication. Doctors also prescribe antibiotics to prevent any infection which might occur after the surgery.
While at home, the patient should keep the hernia repair site clean. If the patient experiences any sign of redness or swelling where the hernia was located, they should seek immediate medical attention. Any abdominal pain or fever should not go unreported.
The surgeon should be the one to remove the outer sutures during a follow-up visit, which should be about one week after the surgery. Patients should avoid strenuous activities for up to one month, but this depends on the type of surgery done. Also, the patients should avoid lifting heavy objects for at least 6 to 8 weeks after laparoscopic incisional hernia repair. This allows proper healing of the muscle tissue.
Cost of Incisional Hernia Repair surgery
Laparoscopic incisional hernia repair surgery cost depends on the type of hospital, type of room and duration of stay in the hospital. However, laparoscopic ventral incisional hernia repair surgery cost is greatly determined by the type of incisional hernia repair surgery and the type of mesh that is used for repair. Generally, the cost of laparoscopic ventral incisional hernia repair surgery is covered by insurance companies in India.