Our Summary

This research paper is about a comparative study of two types of laparoscopic surgeries - single-incision laparoscopic surgery and traditional laparoscopic surgery. The researchers wanted to determine which type of surgery resulted in a higher risk of a patient developing an incisional hernia, a condition where an organ, often part of the intestine, pushes through a surgical wound in the abdominal wall. After analyzing 22 studies involving these two types of surgeries, the researchers found that patients who underwent single-incision laparoscopic surgery were about three times more likely to develop an incisional hernia compared to those who underwent traditional laparoscopic surgery. However, the researchers found no significant difference in the odds of these hernias needing surgical repair. The type of procedure and the method of follow-up also made no difference in the odds of developing an incisional hernia.

FAQs

  1. What are the two types of laparoscopic surgeries compared in this study?
  2. According to the research, which type of laparoscopic surgery has a higher risk of leading to an incisional hernia?
  3. Did the type of procedure and method of follow-up have any impact on the odds of developing an incisional hernia after laparoscopic surgery?

Doctor’s Tip

A helpful tip that a doctor might tell a patient about laparoscopic surgery is to carefully follow post-operative instructions provided by their medical team. This may include avoiding heavy lifting, following a specific diet, and taking prescribed medications as directed. Following these instructions can help reduce the risk of complications, including incisional hernias, and promote a faster and smoother recovery.

Suitable For

Patients who are typically recommended for laparoscopic surgery include those with conditions such as:

  • Gallbladder disease (such as gallstones or inflammation of the gallbladder)
  • Hernias (such as inguinal hernias or ventral hernias)
  • Appendicitis
  • Gastroesophageal reflux disease (GERD)
  • Ovarian cysts or tumors
  • Endometriosis
  • Colon cancer or other colorectal conditions

Laparoscopic surgery is often recommended for patients who are looking for a minimally invasive approach to surgery, as it typically results in smaller incisions, less pain, faster recovery times, and shorter hospital stays compared to traditional open surgery. However, as seen in the research paper mentioned above, the type of laparoscopic surgery performed can also impact the risk of certain complications, such as incisional hernias. Patients should discuss their options with their healthcare provider to determine the best approach for their specific condition.

Timeline

Timeline of a patient’s experience before and after laparoscopic surgery:

Before surgery:

  1. Consultation with a surgeon to discuss the need for surgery and the risks and benefits of laparoscopic surgery.
  2. Pre-operative testing and preparation, including blood tests, imaging scans, and possibly a pre-surgical diet or medication regimen.
  3. Informed consent process, where the patient acknowledges understanding of the procedure and its potential risks.
  4. Pre-operative instructions, such as fasting before surgery and stopping certain medications.

Day of surgery:

  1. Arrival at the hospital or surgical center and check-in process.
  2. Pre-operative preparation, including changing into a hospital gown and having an IV line inserted for anesthesia and fluids.
  3. Anesthesia administration and positioning on the operating table.
  4. Laparoscopic surgery performed by the surgical team, which typically involves making small incisions in the abdomen and inserting a camera and instruments to perform the procedure.
  5. Recovery in the post-anesthesia care unit (PACU) before being transferred to a hospital room or discharged home.

After surgery:

  1. Post-operative care, including monitoring vital signs, pain management, and instructions for wound care and activity restrictions.
  2. Follow-up appointments with the surgeon to assess healing and discuss any potential complications.
  3. Gradual resumption of normal activities and a return to work or school as advised by the surgical team.
  4. Long-term follow-up to monitor for any signs of complications, such as incisional hernias, and to address any ongoing concerns or questions.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with laparoscopic surgery?
  2. How does single-incision laparoscopic surgery differ from traditional laparoscopic surgery in terms of recovery time, scarring, and potential complications?
  3. What is the likelihood of developing an incisional hernia after undergoing laparoscopic surgery?
  4. Are there any specific factors that may increase my risk of developing an incisional hernia after surgery?
  5. What steps can be taken to minimize the risk of developing an incisional hernia post-surgery?
  6. How will the incisional hernia be diagnosed and treated if it occurs after laparoscopic surgery?
  7. What is the success rate of surgical repair for incisional hernias following laparoscopic surgery?
  8. Are there any alternative surgical techniques or approaches that may reduce the risk of developing an incisional hernia?
  9. What is the long-term prognosis for patients who develop an incisional hernia following laparoscopic surgery?
  10. Are there any lifestyle changes or precautions that I should take to prevent the development of an incisional hernia after laparoscopic surgery?

Reference

Authors: Connell MB, Selvam R, Patel SV. Journal: Hernia. 2019 Feb;23(1):91-100. doi: 10.1007/s10029-018-1853-6. Epub 2018 Nov 23. PMID: 30471045