Laparoscopic Hernia Repair: Incisional Ventral and Inguinal

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Laparoscopic Hernia RepairIncisional / Ventral
and Inguinal
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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.

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Where Do Hernias Occur?

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

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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

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Preoperative Work-up

• Evaluation by Surgeon
• Physical Examination
• CT Scan
• May or may not be needed
• At the discretion of the surgeon

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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

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Laparoscopic Ventral Hernia
Laparoscopic Ports
Hernia
10
5
5
5
8
Laparoscopic Inguinal Hernia
Laparoscopic Ports
10
Hernia
Hernia
5
5
9
Ventral Hernia Defect
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Mesh Used to Patch Defect
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Mesh Secured to Abdominal Wall
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Completed Repair
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Complications

• Bleeding
• Mesh Infection
• Injury to Adjacent Organs
• Recurrence

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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)