Laparoscopic Herniorrhaphy

Laparoscopic and robotic-assisted herniorrhaphy usually involve at least three small incisions, one measuring 1.2 centimeters and two measuring about 0.5 centimeter. Surgical tools are used to visualize the hernia from behind. A synthetic mesh is placed to cover the weakness in the muscle and sutured in place.

A hernia occurs when an organ, usually the intestine, or fatty tissue (omentum) squeezes through a weak spot in a surrounding muscle or connective tissue. The most common types of hernia are inguinal (inner groin), umbilical (navel), and incisional (resulting from an incision). The first symptom of hernia is usually a palpable mass that may increase and decrease in size. There may or may not be painful.

  1. In an open herniorrhaphy the anesthesia used may be general or local. The doctor will make an incision where the hernia is and push the organ or tissue back to its original location. The doctor will then repair the opening and place a surgical mesh to strengthen the area. The incision will then be closed. This method may result in more pain than other methods and may require a longer recovery than with minimally invasive procedures like laparoscopic herniorrhaphy or robotic-assisted herniorrhaphy.
  2. A laparoscopic herniorrhaphy is a minimally invasive procedure to repair the weak spot in the abdominal wall by placing a synthetic net over the area and attach it to surrounding muscle. A thin, flexible tube with a camera at the end is used for this procedure and images are displayed onto a monitor. Fiber optics provide light and help the doctor visualize the area clearly and perform the procedure accurately.
Less blood loss and quicker recovery due to the small incisions 

Advantages of Robotic-Assisted Herniorrhaphy
  • Small incisions
  • Less pain after the procedure than in open surgery
  • High accuracy and safety as the doctor can clearly visualize the patient’s organs
  • The robotic arm can move in up to seven directions, ideal for complicated procedures in hard-to-reach locations.
  • Decrease in post-procedure complications
  • In a robotic-assisted herniorrhaphy, the patient will be administered general anesthesia and a breathing tube will be placed. The patient will be positioned on their back. A robotic arm at the patient’s bedside will insert a camera and surgical tools into the patient through 3-4 small incisions made in the abdomen. A doctor will control the robotic arm at a console in the operating room and will perform the surgery by looking at the three-dimensional images displayed of the organs. The images are very clear and can be magnified a good deal. The doctor’s movements are transmitted real time to the robotic arm and the surgical tools.
Advantages of Laparoscopic Herniorrhaphy
  • Small incisions
  • Less pain after the procedure than in open surgery
  • Quicker recovery and return to normal activities
  1. Your doctor will ask you about any allergies you have to medication, your medical history, and any surgery you’ve had.
  2. Please stop taking aspirin and other blood thinners for at least one week before the procedure.
  3. You will need to avoid food and water for at least eight hours before the procedure.
Pain is common after the procedure and can be managed with medication. You can usually eat normal food within hours after the procedure and resume normal activities within three to four days. Any heavy work or heavy lifting should be avoided for three to four weeks. Incisions should be kept dry as instructed by the doctor.
  1. Injury to an artery, the intestines, or the bladder, though this is rare.
  2. Trouble passing urine after the operation.
  3. Swelling of the testicle and scrotum, injury to the vas deferens.
  4. Ongoing pain or discomfort in groin.
  5. Bleeding into the incision.
  6. Recurrence.
  1. If you are taking any blood-thinning medication/anticoagulant, please let your doctor know as some may need to be stopped before you travel for the procedure.
  2. Travelers to Thailand should plan to stay in the country for at least one week or for the entire duration of treatment.
  3. If you plan to return home after the procedure, please speak to your doctor before making travel arrangements. There are no restrictions for air travel.
  4. During your follow-up appointment your medical team will assess your health and your incision and you will receive documents detailing your medical and treatment history and your "Fit to Fly" certificate (if needed).
The success of the procedure depends on a number of factors. Please discuss the likelihood of success with your doctor before the procedure.
What if the procedure is not performed?
A hernia does not resolve itself and can lead to complications, such as intestinal obstruction, which can then become so severe that blood flow to the intestines is compromised. This is an emergency situation. Surgery to treat a hernia is the only solution to prevent further complications.
  1. Truss: A truss may be worn to support the weak area. The truss is not a cure and can be uncomfortable or even dangerous in large hernias. It may cause pressure sores and is not always effective. The proper use of a truss requires medical advice.
  2. Open herniorrhaphy: An incision is made in the groin area. It usually involves a recovery period of up to four weeks before you can resume normal strenuous activities.

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