Hernia Keyhole Surgery

A hernia can be described as any weakness in the abdominal wall muscle that will allow the passage of fat or organs such as small bowel to push through the weakness. A resultant hernia can occur with pain not necessarily being the predominant symptom. Patients may experience a 'bulge' only, which can 'disappear' on lying flat.

The most common types of hernia include:

Inguinal (groin)
Incisional (due to a previous incision/ operation scar)
Femoral (groin)
Umbilical (belly button)
Epigastric (upper abdomen)

Other rarer hernia include:

Spigelian (lower abdomen)
Lumbar (back)

Click here to see a diagram of where your hernia is in relation to the abdomen

MGS has the experience of diagnosing your hernia and recommending the type of surgical repair to suit your appropriate needs. The type of surgical repair include:

Open surgery
Minimal access 'keyhole' or Laparoscopic surgery
Local anaesthesia surgery
Epidural anaesthesia surgery

Open surgery

This is conventional surgery which is performed either under general or local anaesthesia depending upon where the hernia is located. Groin hernia surgery (inguinal/ femoral) can be performed under local anaesthesia and requires a scar in the groin area. A tension free 'Lichtenstein' repair1 is used which relies on strengthening the repair using a polypropylene mesh which is placed over the repair using absorbable sutures. The emphasis on the repair is its 'tension-free' nature thereby reducing immediate short term and long-term groin discomfort.

Incisional hernia surgery can also be undertaken by employing both 'component separation' technique and the 'STOPPA' repair.

Laparoscopic 'keyhole' Surgery

Keyhole surgery is becoming the preferred method of hernia surgery especially for groin herniae. The main advantage of the keyhole repair is the quicker recovery to normal and active physical activities as well as reduced immediate and long-term groin pain2. The National Institute of Clinical Excellence 'NICE' recommends laparoscopic hernia repair for patients with groin hernia but especially for recurrent groin/ inguinal hernia and bilateral (both sides) hernia (click here for NICE guidelines and the European Hernia society guidelines). Incisional and large umbilical hernia surgery can also be undertaken by the keyhole approach, but your surgeon will decide on and recommend the best technique to suit the individual patient's needs. The keyhole repair for incisional hernia can result in equivocal immediate postoperative pain as for the open repair, but it does present with larger more notable benefits with quicker recovery in addition to reduced hospital stay. An incisional hernia with more than one defect, described as 'swiss-cheese' defects, may benefit more from the keyhole repair.

Local anaesthesia

Groin hernia surgery, both inguinal, femoral and sportsman hernia can be undertaken under local anaesthesia. This option is offered to patients that cannot undergo a general anaesthesia due to an underlying medical condition. In addition it will be offered to patients that would prefer to undergo surgery by this technique. A 'tension-free' Lichtenstein technique is employed.

Epidural anaesthesia

This technique involves the insertion of a fine needle into the lower back of patients in order to fully anaesthetise 'numb' the groin area and lower legs. Patients will have no feeling below the waist and therefore allow safe pain free surgery while the patient remains awake. Again this type of anaesthesia is reserved for patients that cannot have a general anaesthetic due to an underlying medical condition or in circumstances where the patient may request no general anaesthesia. Your surgeon will discuss with you all the options during your consultation. A 'tension-free' Lichtenstein technique is employed.