A hernia is a protrusion of part of an organ or tissue through muscle, bone or membrane. Hernias can be abdominal or thoracic, internal or external.
Abdominal and inguinal hernias may follow surgery or appear spontaneously from a congenital weakness. Repair ranges from simple suturing to major reconstruction of the abdominal wall using mesh and muscle flaps, depending on the size and severity of the defect. The tissue or bowel inside the hernia sac is returned to the abdominal cavity, the defect is repaired, and the incision closed.
Open versus laparoscopic repair
In a laparoscopic repair, mesh is placed inside the abdomen without reconstructing the abdominal wall. It is fixed with tacks, staples or sutures. The difference between the two approaches is how the hernia is accessed and exposed.
In open repair the abdominal wall is incised directly over the defect. Disturbing the surrounding tissue can interrupt its blood supply, and larger incisions carry a greater risk of haematoma, seroma and wound infection.
Laparoscopic repair is technically demanding and has been criticised for not restoring the anatomy, which can leave the abdominal wall unstable and the bulge still visible. Its advantages are less pain, quicker recovery, fewer recurrences, a lower infection rate and fewer complications overall.
Mesh was first used in a laparoscopic incisional hernia repair in 1993. Repairing a recurrent hernia is considered a challenging operation, and every attempt raises the chance of a further recurrence, so getting the first repair right matters.
Professor El-Khoury will talk through the operation with you in the rooms, covering why it is being recommended, what it involves, the risks and the benefits. He also provides Royal Australasian College of Surgeons information sheets on the procedure so you can read them at home and bring questions back.
This page is general information, not medical advice. What applies to you depends on your history, your examination and your results. Bring your questions to the consultation.