Laparoscopic Ventral Hernia Repair
Laparoscopic ventral hernia repair is a minimally invasive procedure for repairing a ventral (abdominal) hernia, which occurs when there is a weakness in the abdominal wall that develops into a tear or hole. The hernia is created as the inner lining of the abdomen pushes through the opening, forming a sac into which a portion of abdominal or intestinal tissue protrudes. The hernia manifests itself as a bulge in the outer wall of the abdomen. Depending on its severity, a ventral hernia may or may not require surgical repair. Using laparoscopic surgery rather than traditional open surgery for repair has significant advantages; they include less scarring, less pain, less risk of infection, and a shorter recovery period.
When an organ gets trapped in the hernia (incarceration) or becomes strangulated (blood flow to the organ is cut off), emergency surgery is required. During ventral hernia repair, the surgeon pushes the protruding tissue back into the abdominal cavity, and attaches surgical mesh to the surrounding muscles to strengthen the area.
The Laparoscopic Ventral Hernia Repair Procedure
Laparoscopic ventral hernia repair is typically performed under general anesthesia. The surgeon begins by creating three or four small incisions in the abdomen. A laparoscope and tiny camera are inserted through one of the incisions; the miniature instruments used to repair the hernia are inserted through the others. Usually, mesh in the form of a synthetic patch is used to repair the weakness in the abdominal wall. The patch is held in place with surgical tacks or, in some cases, sutures. In a small number of cases, it may be impossible to use surgical mesh because patients have rejected it in previous surgeries. In these cases, sutures, called primary closures, are used to repair the hernia. Unfortunately, using primary closures results in a higher rate of reherniation.
Risks of Laparoscopic Ventral Hernia Repair
Laparoscopic ventral hernia repair is considered safe, although every surgical procedure has risks, including the following:
- Excessive bleeding
- Blood clots
- Adverse reactions to anesthesia or medication
- Postsurgical infection
- Damage to adjacent organs
- Breathing problems
In the case of a ventral hernia repair, there is also a relatively high risk of reherniation and the need for further surgery, though this risk is lessened by abstaining from smoking, and following other postoperative instructions. Moreover, the risk involved in not repairing a ventral hernia is typically far greater than the surgery itself, because the hernia can become incarcerated or strangulated.
Recovery from Laparoscopic Ventral Hernia Repair
Recovery from laparoscopic ventral hernia repair is usually uneventful. Immediately after surgery, rest is necessary. A diet high in fiber is recommended to avoid constipation. Within a day, the patient can walk and, within a week, can resume normal activities. More strenuous activities, such as playing sports, lifting heavy items or engaging in sexual activity, may not be permitted for several weeks. Any issues, such as obesity or chronic coughing, that led to or exacerbated the development of the hernia, must be addressed.