Our Summary

This research paper is examining the best surgical approach for smaller incisional hernias (less than 10 cm). The two methods they’re looking at are a totally laparoscopic or “keyhole” surgery, and a hybrid approach which combines keyhole and open surgery. Both methods use a mesh to reinforce the area where the hernia was. The study looked at 164 patients who had hernia repair surgery between 2015 and 2020 at two hospitals.

The researchers looked at things like the patients’ age, sex, body mass index (BMI), and hernia size, as well as outcomes like surgical site infection, complications, length of hospital stay, post-op pain, and whether the hernia came back.

They found that there wasn’t a notable difference in post-op pain, infection, complications, or hernia recurrence between the two surgical methods. The time until a hernia recurred also wasn’t significantly different. However, the hybrid method was used more often in patients with a higher BMI and larger hernias, without causing more complications.

The conclusion is that the hybrid approach (combining open and keyhole surgery) is just as effective as totally keyhole surgery for repairing smaller hernias. The hybrid approach can be particularly useful in patients with a higher BMI and hernias up to 6 cm.

FAQs

  1. What are the two methods of hernia repair surgery that the research paper examined?
  2. Was there a notable difference in post-op pain, infection, complications, or hernia recurrence between the two surgical methods?
  3. Which surgical method was found to be more effective for patients with a higher BMI and hernias up to 6 cm?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic hernia repair is to discuss with their surgeon the possibility of a hybrid approach, which combines keyhole and open surgery. This method may be just as effective as totally laparoscopic surgery for repairing smaller hernias, especially for patients with a higher BMI or larger hernias. It’s important to have a thorough discussion with your surgeon about the best approach for your specific situation.

Suitable For

Patients who are typically recommended for laparoscopic hernia repair include those with smaller incisional hernias (less than 10 cm) who are looking for a minimally invasive surgical approach. Additionally, patients with higher BMI and larger hernias may also benefit from a hybrid approach that combines open and laparoscopic techniques. Ultimately, the decision on the best surgical approach should be made on a case-by-case basis, taking into consideration factors such as age, sex, BMI, hernia size, and overall health of the patient.

Timeline

Before the laparoscopic hernia repair:

  • Patient notices a bulge or discomfort in the abdomen
  • Patient consults with a healthcare provider who diagnoses a hernia
  • Patient undergoes pre-operative testing and evaluation
  • Surgery date is scheduled

After the laparoscopic hernia repair:

  • Patient arrives at the hospital on the day of surgery
  • Patient is prepped for surgery and given anesthesia
  • Surgeon makes small incisions in the abdomen and inserts a laparoscope to repair the hernia
  • Mesh is placed over the hernia to reinforce the area
  • Surgery typically lasts around 1-2 hours
  • Patient is monitored in the recovery room before being discharged
  • Patient may experience some pain and discomfort in the days following surgery
  • Patient is advised to avoid heavy lifting and strenuous activity for a few weeks
  • Follow-up appointments are scheduled to monitor recovery and ensure the hernia has healed properly.

What to Ask Your Doctor

Some questions a patient should ask their doctor about laparoscopic hernia repair include:

  1. What are the potential risks and complications associated with laparoscopic hernia repair surgery?
  2. How long will the surgery take and what is the expected recovery time?
  3. Will I need to stay in the hospital after the surgery, and if so, for how long?
  4. How soon can I return to normal activities, such as work and exercise, after the surgery?
  5. Will I need to follow any specific post-operative care instructions or restrictions?
  6. What are the chances of the hernia recurring after surgery?
  7. Will I need to use any special equipment or devices, such as a hernia belt, after the surgery?
  8. How will the hernia repair surgery affect my daily life and activities in the long term?
  9. Are there any alternative treatments or surgical approaches that I should consider?
  10. What is the surgeon’s experience and success rate with laparoscopic hernia repair surgery?

Reference

Authors: Melland-Smith M, Khan U, Smith L, Tan J. Journal: Hernia. 2022 Jun;26(3):945-951. doi: 10.1007/s10029-021-02443-3. Epub 2021 Jul 23. PMID: 34297250