Laparoscopic Hernia Repair:

Incisional / Ventral and Inguinal

What is a Hernia?
DEFECT IN THE FASCIA
The fascia is the strength layer surrounding the abdominal cavity A defect in that layer allows intra-abdominal contents (i.e.. fat, intestines) to bulge through the defect.

Where Do Hernias Occur?

Abdominal Wall
At a previous surgical incision At the umbilicus Above the umbilicus (epigastrium) In the inguinal region (groin)

Who Requires Treatment?

Pain or Discomfort Enlarging Hernias Intestinal Obstruction
Nausea, Vomiting, Abdominal Distention

Incarceration or Strangulation
Hernia Contents are trapped and painful Abdominal Pain and/or a Painful Bulge Blood Supply to trapped contents may be compromised

Preoperative Work-up
Evaluation by Surgeon
Physical Examination

CT Scan
May or may not be needed At the discretion of the surgeon

Surgical Technique
Key Components:
Reduce the hernia contents Patch the defect in the fascia with Mesh
Mesh is incorporated into the abdominal wall by the body Reinforces the defect in the fascia

Secure the Mesh to the abdominal wall

Prevent movement of the mesh prior to incorporation

Laparoscopic Ventral Hernia

Laparoscopic Ports
Hernia

10

Laparoscopic Inguinal Hernia

Laparoscopic Ports

Hernia

10

Hernia

5
5

Ventral Hernia Defect

Mesh Used to Patch Defect

Mesh Secured to Abdominal Wall

Completed Repair

Complications
Bleeding Mesh Infection Injury to Adjacent Organs Recurrence

Advantages
Decreased Wound Complications Potentially, theorize decrease recurrences; exposes entire undersurface to identify small defects that lead to recurrences
Laparoscopic repair can diagnose the Swiss cheese hernias

Effective modality for recurrent hernias that have been repaired anteriorly (Open)