Best Laparoscopic Hernia Surgery in Delhi, India

A hernia is characterized by the bulging of an organ or tissue through an opening in its surrounding tissue or muscle that holds it. It can occur because the abdominal wall gets weak. Hernias are painful and can prove to be life-threatening. A sudden increase in pressure around the abdominal wall may cause this. Various activities linked to this increased pressure include lifting weights or a heavy object, continuous vigorous coughing or sneezing and, in some cases, diarrhea. Multiple types of hernias include inguinal hernia, femoral hernia, incisional hernia, hiatus hernia and umbilical hernia. Less commonly seen hernias are epigastric hernia and Spigelian hernia.

Hernias require immediate medical attention in the following cases:

• If the hernia is extremely painful.
• If the hernia proliferates and appears swollen.
• The patient has a fever.
• The patient is having constipation.

Symptoms of a Hernia 

• Episodes of pain while lifting an object
• Nausea
• Constipation
• A prominent swelling near the areas of the groin or abdomen
• Dull pain
• Feeling of fullness

A laparoscopic hernia repair is a minimally invasive surgical procedure to treat and repair various hernias. The procedure comprises three to four small incisions and an instrument called a laparoscope with (a thin tube with a camera at the end) to guide the doctor. In some cases, the mesh may be used to hold the bulging tissues in their place. A laparoscopic hernia repair procedure usually takes around one hour to complete. This technique is primarily used to repair those hernias which are smaller in size and less complex. Incisional hernia, groin hernia, and recurrent hernia are among the hernias that are commonly repaired through laparoscopic surgery.

Techniques of Hernia Surgery

Laparoscopic hernia repair is carried out through two techniques, which are as follows:

• Transabdominal Preperitoneal Approach (TAPP): In this approach, the peritoneum layer is incised and requires closure after mesh placement. In this technique, port placement plays a significant role. Therefore, the three ports are placed at the level of the umbilicus and the area of the midclavicular line at the level of the umbilicus on the left and right side of the abdominal area. With the help of these port positions, the surgeon can repair bilateral inguinal hernias.
• The Extraperitoneal Approach (TEP): In the TEP approach, the preperitoneal space is incised at the level of the umbilicus and is not interrupted during the procedures. In a TEP technique, the e-ports are typically placed in a line from the pubic bone to the umbilicus.

Procedure Details for Laparoscopic Hernia Surgery

Before the Procedure

The patient is expected to follow up and share valuable information with the doctor. These are as follows:

• Inform the doctor about the routine medications for various ailments, if any, and a detailed medical history of those conditions.
• Avoid ibuprofen, aspirin or any other blood thinners at least one week before undergoing the procedure as it will interfere with the blood clotting mechanism, thereby causing excessive bleeding after the procedure and resulting in delayed healing.
• It is advised not to consume anything after midnight before the day of surgery.
• Avoid smoking at least three weeks before this procedure, as it worsens the symptoms.

During the Procedure

Laparoscopic surgery is done under general anesthesia, so the patient is asleep during the procedure. The doctor makes three to four small incisions around the site of the hernia, out of which one incision will measure less than one inch in size, whereas the other incisions are a bit smaller.

A laparoscope with a tiny camera placed on the end is inserted through one incision to help the surgeon continue the procedure. The remaining surgical equipments are inserted through the other incisions.

After this, the abdomen is inflated with carbon dioxide gas, which is safe, or with a balloon in very few cases. This aims to create space for the surgeon to work more precisely. The surgeon then carefully pulls the contents of the hernia back to their natural position, after which a part of mesh is placed on the inner side of the gap to reinforce the weakened area of the abdominal wall.

Benefits of Laparoscopic Hernia Surgery

Since this procedure is a minimally invasive technique, hence it has the following advantages for patients:

• Smaller size of the incisions
• Lower risk of infection
• Lesser pain
• Shorter recovery time for the patients
• Quick resumption to work as well as other activities
• Smaller space is required to carry out this procedure.

Risks of Laparoscopic Hernia Repair

Just like any other surgery, the laparoscopic hernia repair comes with a few complications, which are as follows:

• Infection
• Recurrence of hernia
• Reaction towards anesthesia

Outlook of Laparoscopic Hernia Surgery

Most patients get discharged from the hospital premises and return home on the same day or a day after the procedure. However, the number of days a patient is expected to stay in the hospital following this procedure depends on the patient’s overall health. Ideally, the patients can resume their work within one week of surgery and indulge in their daily and routine activities within one to two weeks. 

Review 

Reviewed By Dr Ashish Sachan, Senior Consultant - GI Surgery, Minimal Access & Bariatric Surgery on 10 June 2024.