Laparoscopic Inguinal Hernia Repair Surgery

Inguinal hernia or any other type of hernia can be very problematic for the person. The condition can be managed for some time, but ultimately surgical repair will be needed. That’s why Pristyn Care provides advanced treatment for inguinal hernia and other types of hernias. We leverage the laparoscopic technique for the repair, which is minimally invasive and has significant advantages over the traditional approach. 

Pristyn Care houses modern technology and USFDA-approved diagnostic and surgical tools. We also have an in-house team of general and laparoscopic surgeons who have 10+ years of experience in treating all types of hernias. Our surgeons have a success rate higher than 95% in treating inguinal hernias. You can book a consultation with our doctors for free and discuss what the treatment entails. 

Diagnosis 

To diagnose the hernia, the doctor will ask for your medical history and conduct a physical examination. During the exam, the doctor will check for the bulge while you are standing and ask you to cough as it makes the hernia more prominent. The doctor may also ask you to lie down to check the groin region and the bulge. 

Once it is confirmed that you have an inguinal hernia, the doctor will suggest imaging tests to determine the best treatment method. The following tests are recommended before inguinal hernia repair surgery- 

• Abdominal Ultrasound is done to assess the condition and its severity. 
• CT Scan is done to get clear images of the internal structures as it helps to distinguish hernias from other masses of the abdomen. 
• MRI scan is performed to plan the most appropriate treatment pathway and method for inguinal hernia. 

The results of these tests help the doctor to determine which technique would be most appropriate for inguinal hernia treatment. 

Procedure 

The steps involved in the surgery are explained below- 

• An anesthetist will give you anesthesia (local, regional, or general, depending on the technique used for the surgery). As the anesthesia takes effect, you won’t be able to feel any kind of pain or discomfort. 
• Incisions will be made across the abdomen. If the open technique is being used, then a large incision will be made in the abdomen. If the laparoscopic technique is being used, then the surgeon will make 2-3 keyhole-sized incisions across the abdomen to insert the surgical equipment. 
• The herniated organ or tissue is pushed back to the original location, and the hole is closed with or without the help of the hernia mesh. 
• Once the muscle wall is repaired, the stitches are closed with the help of stitches, staples, or surgical glue. 

You will be transferred to an observation room until the anesthesia wears off and then moved back to your ward, where you’ll rest for the day.

Similar to other surgical procedures, the following complications can arise during inguinal hernia surgery:

• Reaction to anesthesia
• Injury to the internal organs
• Excessive bleeding
• Infection

In addition, even after inguinal hernia surgery is complete, for a month or so until the recovery is complete, there are chances of post-surgery complications, such as-

• Mesh Infection
• Severe pain in the wound or stitches
• Seroma or fluid accumulation
• Hematoma or blood accumulation
• Wound infection
• Urinary retention
• Recurrence

To make sure that these complications don’t arise, the doctor gives a detailed recovery plan with clear instructions on the dos and don’ts after inguinal hernia repair surgery.

The preparation for inguinal hernia repair involves the following steps- 

• You have to avoid eating or drinking anything at least 6-8 hours before the surgery. 
• Give the list of medications that you take on a regular basis to the doctor so that he/she can adjust the medications accordingly. Some medicines can react with anesthetic agents and may cause reactions in the body. Thus, it is important that the medicines are checked and adjusted before the surgery if required. 
• Avoid taking aspirin, blood thinners, or anti-inflammatory medications at least a week before the surgery. 
• Get evaluated properly to eliminate the chances of any underlying medical condition that can impact the outcome of the surgery. 
• Take a shower on the day of surgery and wear loose and comfortable clothes that don’t restrict your movement or rub against the body. 
• Ask a friend or family member to accompany you on the day of surgery.

Immediately after the inguinal hernia surgery, you will feel numb and have little or no sensation in the surgical site. IV fluids and pain medications will be given to you to manage the pain when the anesthesia wears off. 

In many cases, when hernia surgery is done electively without any complication, the patient is discharged on the same day. However, in complex cases, the doctor may suggest hospitalization for more than 24 hours to ensure that there are no post-surgery complications. 

During discharge, the doctor will also give you a recovery guide that will help you get back on your feet as soon as possible.

The laparoscopic hernia repair technique is preferred by patients and doctors because it has the following benefits- 

• Incisions are smaller than open surgery and provide a better cosmetic result.
• The post-operative pain, swelling, and discomfort are reduced due to the minimally invasive nature of the surgery. 
• Recovery is faster, and there are almost negligible chances of post-surgery complications. 
• Chances of bleeding and infection during and after the surgery are also minimal. 
• The patient can return to their regular routine faster as the tiny incisions heal quickly. 
• Almost negligible chances of recurrence of hernia and occurrence of an incisional hernia.

The different techniques that can be used for inguinal hernia repair are- 

Open Surgery- It is the traditional approach to repair inguinal hernia and other types of hernia too. It involves making a large incision around the groin region to access the herniated organ. The bulging organ is pushed back, and the perforation in the wall is repaired with or without using hernia mesh. 

Laparoscopic Surgery– It is a comparatively advanced procedure that involves repairing the inguinal hernia with the help of a laparoscope (a device that has a camera connected to an end). The procedure is minimally invasive in nature as keyhole-sized incisions are made across the abdomen and groin region. The herniated organ is pushed back, and the hole in the muscle wall is repaired with or without hernia mesh. 

Robotic Surgery– This technique is quite similar to laparoscopic hernia repair except that the procedure is carried out by robotic arms. The surgeon controls the robotic arm using a console and handles the surgical instruments. 

All three techniques of hernia repair are effective in treating the condition. Generally, robotic surgery is performed on children for safety reasons, and laparoscopic hernia repair is preferred for adult patients who don’t want a large scar from the procedure. 

If the inguinal hernia is not bothering the patient and there are no clear symptoms, the doctor will recommend watchful waiting. If required, the doctor may also suggest using a supportive truss to help the patient get relief from the symptoms. 

When left untreated for a long time, an inguinal hernia can lead to the following complications- 

• Excessive Pressure- The protruding tissues of the hernia will put excess pressure on the groin, which can be very painful. In males, an inguinal hernia can be more problematic as it puts pressure on the scrotum. 
• Incarceration– Another complication that can arise when the hernia is not treated for a long time is incarceration. The contents of the hernia may become trapped in the abdominal cavity, and it may cause bowel obstruction. Due to this, you won’t be able to pass stools, and the hernia will hurt immensely. 
• Strangulation– In case the blood supply to the herniated tissue is blocked, it will cause strangulation. As a result, the tissues will start to die off and put your life at risk. 

In case any of these complications arise, you will need emergency surgical treatment.

The recovery after inguinal hernia surgery depends on the technique used. When the laparoscopic technique is used for the repair, the complete recovery takes around 3-4 weeks. You will be able to resume normal activities like walking, climbing stairs, sitting, etc., within the first week, but the surgical wound would need longer for recovery. 

In case open surgery is performed to repair the hernia, the recovery rate will be slow, and you may need around 4-6 weeks to recover completely and return to your normal routine. 

Once the surgical repair is complete, you will get relief from the symptoms, including the bulge, pain, nausea, etc. The results of the surgery will appear immediately. The after-effects of inguinal hernia repair surgery will also resolve after some time, and there won’t be any lingering symptoms of inguinal hernia. 

A patient named Sriniwas Kumar (name changed) was diagnosed with the condition 3 years earlier. The symptoms started to get worse around 17th April 2022 and he came to us for help on the same day. Dr. Sajeet Nayar was available at the earliest. So, the case was assigned to him. 

Dr. Sajeet is one of our best surgeons in Bangalore. He looked at the patient’s condition and recommended inguinal hernia repair surgery. The laparoscopic technique was chosen and the procedure was carried out two days later on 19th April 2022. The surgery was performed as scheduled and the patient was discharged on the same day. 

Sriniwas took two follow-ups with the doctor and followed all the instructions. He resumed the work in 7 days and completely recovered within 2 weeks.  The surgery was successful and the patient got full relief without any hassle.