Our Summary

This research paper discusses the advantages of open anterior repair for inguinal hernia, a surgery to fix a weak spot in the abdominal wall. This method is compared to an endoscopic repair, which uses a camera and special tools.

According to the paper, the traditional open repair has several benefits. One is that it’s easier to learn and perform than the endoscopic technique, which has a long learning curve. This means that even less experienced surgeons and supervised students can achieve similar results to expert surgeons when using the open repair method.

Another advantage is that open repair is more affordable because it doesn’t require any special equipment or instruments, except for a prosthetic mesh. This makes it possible to perform the surgery in any operating room, even in locations with limited resources.

The paper also highlights that open repair can be done under local anesthesia, which only numbs a small area of the body. However, it points out that using local anesthesia requires training, a detailed understanding of the anatomy, good technique, patience, and careful handling of body tissues.

The authors conclude that every surgeon should know how to perform an open inguinal hernia repair. This procedure is necessary to treat two conditions: a recurrence of groin hernia after a previous surgery (both laparoscopic and open) and a syndrome causing pain in the groin and pubic area.

FAQs

  1. What are the advantages of open anterior repair for inguinal hernia over endoscopic repair?
  2. Can open tension-free hernia repair be performed under local anesthesia?
  3. What conditions can be treated with open inguinal hernia repair?

Doctor’s Tip

A doctor may advise a patient undergoing hernia repair surgery to follow post-operative care instructions carefully, including avoiding heavy lifting or strenuous activities for a period of time to allow for proper healing. They may also recommend maintaining a healthy weight and avoiding activities that could put strain on the surgical site to prevent recurrence of the hernia. It is important to follow up with the doctor for any concerns or complications that may arise after surgery.

Suitable For

Patients who are typically recommended for hernia repair include those with primary inguinal hernias, recurrent groin hernias after a posterior approach (both laparoscopic and open), and pubic inguinal pain syndrome. Open tension-free repair, such as the Lichtenstein technique, is a suitable option for these patients, as it offers several advantages over endoscopic repair, including ease of teaching and replication, comparable outcomes between experts and non-experts, and feasibility in any operating room with limited costs. Additionally, open tension-free repair can be performed under local anesthesia, making it a valuable option for patients who may not be candidates for general anesthesia.

Timeline

Before hernia repair:

  • Patient experiences symptoms such as pain, swelling, and a bulge in the affected area
  • Patient may undergo diagnostic tests such as physical examination, ultrasound, or MRI to confirm the presence of a hernia
  • Patient may be advised to avoid strenuous activities and wear a supportive garment to alleviate symptoms

After hernia repair:

  • Patient undergoes the surgical procedure, which may be performed under local or general anesthesia
  • Recovery time varies depending on the type of repair, but typically involves rest, pain management, and avoiding heavy lifting or strenuous activities
  • Patient may experience some discomfort, bruising, and swelling in the surgical area, which usually resolves within a few weeks
  • Follow-up appointments with the surgeon are scheduled to monitor healing and address any concerns or complications
  • Patient gradually resumes normal activities and should experience relief from hernia symptoms

Overall, hernia repair surgery aims to alleviate symptoms, prevent complications, and improve quality of life for the patient.

What to Ask Your Doctor

  1. What are the different types of hernia repair procedures available for my specific case, and what are the benefits and risks of each?

  2. How experienced are you in performing hernia repair surgeries, and what is your success rate with this procedure?

  3. Will I need general anesthesia or can the surgery be done under local anesthesia? What are the advantages and disadvantages of each option?

  4. How long is the recovery process after hernia repair surgery, and what activities should I avoid during this time?

  5. What are the potential complications or side effects associated with hernia repair surgery, and how likely are they to occur in my case?

  6. Will I need to wear a hernia support garment or take any medications after the surgery, and for how long?

  7. How long can I expect the results of the hernia repair surgery to last, and are there any factors that may increase the risk of hernia recurrence in the future?

  8. Are there any specific lifestyle changes or precautions I should take to prevent future hernias or complications after the surgery?

  9. How often should I follow up with you after the hernia repair surgery, and what signs or symptoms should I watch out for that may indicate a problem?

  10. Are there any alternative treatments or approaches to hernia repair that I should consider, and how do they compare to the traditional surgical options?

Reference

Authors: Campanelli G, Bruni PG, Morlacchi A, Lombardo F, Cavalli M. Journal: Asian J Endosc Surg. 2017 Aug;10(3):236-243. doi: 10.1111/ases.12394. PMID: 28727316