Our Summary

This research paper is about a type of abdominal hernia called Spigelian hernias (SHs), which account for 1% to 2% of all abdominal hernias. Traditionally, these hernias have been repaired through open surgery. However, since 1992, less invasive laparoscopic methods (which involve small incisions and the use of a camera) have become more common. The researchers looked at various databases for studies on laparoscopic repair of SHs.

They didn’t find any rigorous studies comparing different laparoscopic techniques, but they did find 50 articles for review. In total, 237 SHs were repaired using different techniques. The most popular method was the “intraperitoneal onlay mesh technique,” which involves placing a mesh on the inside of the abdominal wall. All the techniques had few complications and recurrences.

The researchers concluded that there are several laparoscopic techniques available for repairing SHs, and overall, these methods are safe and acceptable.

FAQs

  1. What is a Spigelian hernia and how common is it?
  2. What are the current trends in laparoscopic repair of Spigelian hernias?
  3. Is laparoscopic repair of Spigelian hernias considered a safe and acceptable method?

Doctor’s Tip

One helpful tip a doctor might tell a patient about laparoscopic hernia repair is to follow post-operative instructions carefully, including avoiding heavy lifting and strenuous activity for a certain period of time to allow for proper healing of the surgical site. It is also important to attend follow-up appointments with your doctor to ensure that the hernia repair is successful and to address any concerns or complications that may arise.

Suitable For

Patients who are typically recommended for laparoscopic hernia repair include those with Spigelian hernias, which account for 1% to 2% of abdominal wall hernias. The laparoscopic methods have become increasingly popular since 1992, with various techniques being described in the literature. Overall, laparoscopic repair of Spigelian hernias is considered safe and effective with minimal complications and recurrences reported in various techniques.

Timeline

Before laparoscopic hernia repair:

  1. Patient experiences symptoms of a hernia, such as pain, discomfort, or a bulge in the abdomen.
  2. Patient consults with a healthcare provider who diagnoses the hernia and recommends treatment.
  3. Patient undergoes preoperative testing and preparation for surgery, which may include fasting and stopping certain medications.
  4. Patient discusses the risks and benefits of laparoscopic hernia repair with their surgeon and gives informed consent for the procedure.

After laparoscopic hernia repair:

  1. Patient undergoes the laparoscopic hernia repair procedure, which involves making small incisions in the abdomen and inserting a laparoscope to repair the hernia with mesh.
  2. Patient is monitored in the recovery room before being discharged home the same day or the following day.
  3. Patient may experience some pain, swelling, or discomfort at the incision sites, which can be managed with pain medication.
  4. Patient is instructed on postoperative care, including avoiding strenuous activities, lifting heavy objects, and taking care of the incision sites.
  5. Patient follows up with their surgeon for postoperative appointments to monitor healing and address any concerns or complications.
  6. Patient gradually resumes normal activities and should experience relief from hernia symptoms.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with laparoscopic hernia repair?
  2. How long is the recovery time after laparoscopic hernia repair?
  3. Will I need to follow any special post-operative care instructions?
  4. What are the chances of the hernia recurring after laparoscopic repair?
  5. How experienced are you in performing laparoscopic hernia repairs?
  6. Are there any alternative treatment options to consider?
  7. How soon after surgery can I resume normal activities and exercise?
  8. Will I need to follow a specific diet before or after the surgery?
  9. What type of anesthesia will be used during the procedure?
  10. How will I know if the hernia repair was successful?

Reference

Authors: Barnes TG, McWhinnie DL. Journal: Surg Laparosc Endosc Percutan Tech. 2016 Aug;26(4):265-70. doi: 10.1097/SLE.0000000000000286. PMID: 27438174