Treatment of abdominal wall hernias is always surgery. The type of surgery depends on the hernia size and location, the patient’s health, age, anesthesia risk and the surgeon’s expertise.
In open hernia repair, the surgeon makes an incision on the skin near or over the hernia site. The defect in the abdominal wall muscles is repaired using a mesh that is sutured (sewn) or stapled to strong tissues next to the hernia site. Mesh plugs can also be placed into the inguinal or femoral hernia space. An open hernia repair has the advantage that can be done under local anesthesia.
Laparoscopic repair of abdominal wall hernias
Laparoscopic repair of abdominal wall hernias, is a relatively new method that is being applied by surgeons throughout the world with great enthousiasm.
The surgeon will make several tiny punctures or incisions in the abdomen. Ports are then inserted into the openings and the abdomen is insufflated with carbon dioxide gas to increase the working space and visualize better the abdominal organs. Surgical tools and a laparoscope (telescope) are progressively placed into the ports. The hernia is repaired with mesh, stapled or glued in place.
The repair can be done as a TransAbdominal PrePeritoneal (T.A.P.P.) procedure (see the video), meaning the peritoneum (the sac that contains all the abdominal organs is entered), or as a Totally ExtraPeritoneal(T.E.P.) procedure (see the video).
The laparoscopic repair offers a faster recovery and return to everyday activities and is associated with less pain and numbness. Long-term outcomes, though, with respect to recurrence and complications are very similar to the open repair.