Minimally Invasive (laparoscopic or robotic) Hernia Repair

Hernias are a common condition that affects millions of people worldwide. They occur when an organ or tissue protrudes through a weak spot or opening in the surrounding muscle or connective tissue. While hernias can develop in various parts of the body, the most common types occur in the abdominal wall, groin, and diaphragm.

Hernias can cause discomfort, pain, and other symptoms that affect daily life. If left untreated, they can lead to complications such as bowel obstruction, strangulation, and tissue damage. Hernia repair is the most effective treatment option for hernias, and minimally invasive hernia repair, wether laparoscopic or robotic, has become an increasingly popular approach in recent years. In this article Dr. Iskandar answers some of the most frequently asked questions regarding laparoscopic hernia repair. As the leading complex hernia specialist in the Dallas-Fort Worth area, Dr. Iskandar has a wealth of experience in treating hernias laparoscopically and robotically. For more information or to schedule your consultation with Dr. Iskandar, call The Iskandar Complex Hernia Center now.

What is Laparoscopic Hernia Repair?

Laparoscopic or robotic hernia repair is a minimally invasive surgical procedure that uses a laparoscope, a thin, flexible tube with a camera and light, to repair the hernia. The surgeon makes small incisions in the abdomen, inserts the laparoscope and other surgical tools, and repairs the hernia from the inside. Carbon dioxide gas may be used to inflate (make larger) your abdominal cavity. The gas will allow your caregiver to better see the area in need of repair. If a robotic approach is chosen the robotic instruments are introduced through small incisions just like in laparoscopy and are controlled by the surgeon.

During the procedure, the surgeon places a mesh patch over the weakened or torn tissue to reinforce the abdominal wall and prevent the hernia from recurring. The mesh is secured in place with sutures or staples and eventually becomes incorporated into the surrounding tissue.

Benefits of Minimally Invasive Hernia Repair

Compared to traditional open hernia repair surgery, minimally invasive hernia repair offers several advantages, including:

  1. Faster Recovery Time: Because laparoscopic or robotic hernia repair is minimally invasive, it causes less trauma to the surrounding tissue and muscles. This means that patients experience less pain and discomfort after the surgery and can usually return to their normal activities sooner.
  2. Less Scarring: The small incisions used in minimally invasive hernia repair result in smaller scars than those from open surgery.
  3. Lower Risk of Infection: The risk of infection is reduced because the surgical incisions are smaller, and the procedure is less invasive.
  4. Reduced Hospital Stay: Most laparoscopic or robotic hernia repair procedures are performed on an outpatient basis, which means patients can go home the same day.
  5. Reduced Risk of Recurrence: The use of mesh to reinforce the abdominal wall during laparoscopic or robotic hernia repair reduces the risk of the hernia recurring.

Who is a Candidate for a Minimally Invasive Laparoscopic Hernia Repair?

Minimally invasive hernia repair is a safe and effective treatment option for most people with hernias. However, the decision to undergo laparoscopic or robotic hernia repair depends on several factors, including the type and size of the hernia, the patient’s overall health, and the surgeon’s expertise.

In general, laparoscopic hernia repair may not be recommended for patients with large, complicated hernias or those with underlying health conditions that increase the risk of complications. Robotic surgery has allowed some hernias that were typically approached open to be done in a minimally invasive fashion due to the added functionality of the robot. Patients should discuss their options with their surgeon to determine whether laparoscopic hernia repair is the right choice for them.

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More FAQ’s about Laparoscopic and Robotic Hernia Repairs

How is laparoscopic or robotic hernia surgery done?

During laparoscopic hernia surgery, the surgeon makes several small incisions in the abdomen and inserts a laparoscope, a thin tube with a camera and light, and other surgical tools. The laparoscope allows the surgeon to see inside the abdomen and repair the hernia from the inside. If a robotic approach is chosen the robotic instruments are introduced through small incisions just like in laparoscopy and are controlled by the surgeon.

The defect in the muscle is closed with sutures. A mesh patch is placed over the weakened or torn tissue to reinforce the abdominal wall and prevent the hernia from recurring. The mesh is secured in place with sutures or staples and eventually becomes incorporated into the surrounding tissue. Laparoscopic or robotic hernia surgery is minimally invasive and associated with a shorter recovery time and less scarring than traditional open surgery.

How safe is laparoscopic and robotic hernia surgery?

Laparoscopic or robotic hernia surgery is generally considered a safe procedure with a low risk of complications. Studies have shown that the overall complication rate for laparoscopic or robotic hernia repair is less than 5%. The most common complications include bleeding, infection, and chronic pain. However, the risk of complications can vary depending on several factors, including the type and size of the hernia, the patient’s overall health, and the surgeon’s expertise. Patients should discuss the potential risks and benefits of minimally invasive hernia surgery with their surgeon to determine whether it is a suitable treatment option for them.

What types of hernias can be repaired with minimally invasive surgery?

Laparoscopic or robotic hernia repair is used for treating the majority of hernias. Individuals with the following types of hernias may qualify for minimally invasive hernia repair:

  • Ventral hernia – Ventral hernias include Incisional hernia, Epigastric hernia, Umbilical hernia.
  • Recurrent hernia – A recurrent hernia is characterized by a painful bulge that occurs at or around the original hernia site.
  • Groin hernia – A hernia is a protrusion that results from weakening abdominal muscles. When abdominal muscles are weaker, abdominal tissues and/or organs such as the intestines can protrude into this area. This condition is known as a groin hernia or an inguinal hernia when it affects the lower abdominal wall in the groin region.

How many incisions are made for laparoscopic or robotic hernia repair?

During laparoscopic or robotic hernia repair, the surgeon typically makes three to four small incisions in the abdomen, each ranging from 5 to 8 millimeters in length. One of the incisions is used to insert the laparoscope, while the others are used to insert other surgical tools.

The small incisions are less invasive than the larger incision required for traditional open hernia repair surgery and typically result in less pain, scarring, and a faster recovery time. The number and location of incisions may vary depending on the size and location of the hernia and the surgeon’s preference.

How painful is minimally invasive hernia surgery?

Minimally invasive laparoscopic hernia surgery is generally less painful than traditional open hernia repair surgery. The small incisions used cause less trauma to the surrounding tissue and muscles, resulting in less pain and discomfort after the surgery. Patients may experience some discomfort, edema (swelling), or soreness at the incision sites and in the abdomen in the days following the procedure.

However, this discomfort is typically manageable with over-the-counter pain medications and resolves within a few days to a week. The level of pain and discomfort may vary depending on several factors, including the type and size of the hernia and the patient’s pain tolerance.

How long does minimally invasive hernia repair surgery take?

The duration of minimally hernia repair surgery can vary depending on several factors, including the size and location of the hernia and the surgeon’s expertise. However, the procedure typically takes between 30 minutes to two hours to complete. The surgeon will first insert the laparoscope and other surgical tools through small incisions in the abdomen and then repair the hernia from the inside using a mesh patch. The mesh is secured in place with a surgical suture or staples, and the incisions are closed with dissolvable stitches.

Patients may require a few hours of observation in the recovery room as anesthesia is wearing off before being discharged home the same day. Some complex hernias may require more time and an overnight stay in the hospital.

What is a minimally invasive ventral hernia repair?

Laparoscopic or robotic ventral hernia repair is a minimally invasive hernia repair procedure used to treat a hernia that has developed in the abdominal wall. During the procedure, the surgeon makes several small incisions in the abdomen and inserts a laparoscope, a thin tube with a camera and light, and other surgical tools.

The laparoscope allows the surgeon to see inside the abdomen and repair the hernia from the inside using a mesh patch. The mesh is secured in place with sutures or staples, and the incisions are closed with dissolvable stitches. Laparoscopic ventral hernia repair is associated with a shorter recovery time and less scarring than traditional open surgery.

What is laparoscopic or robotic inguinal hernia repair?

Laparoscopic or robotic inguinal hernia repair, also known as keyhole inguinal hernia repair, is a surgical procedure used to treat a hernia that has developed in the groin area. The keyhole surgery to repair inguinal hernias involves making several small incisions in the abdomen, through which a laparoscope and other surgical instruments are inserted. The laparoscope provides the surgeon with a clear view of the affected space, allowing them to repair the hernia from the inside using a mesh patch. The mesh is secured in place with sutures or staples, and the incisions are closed with dissolvable stitches.

Compared to traditional open inguinal hernia repair surgery, laparoscopic or robotic inguinal hernia repair is less invasive, resulting in less scarring, less pain, and a shorter recovery time.

Which is better, open, laparoscopic or robotic hernia repair?

The choice between open, laparoscopic, or robotic hernia repair depends on several factors, including the size and location of the hernia, the patient’s overall health, and the surgeon’s expertise. Laparoscopic or robotic hernia repair is a minimally invasive procedure associated with less postoperative chronic pain, scarring and a quicker recovery time than open surgery.

However, some patients are candidates for laparoscopic or robotic surgery, and in some cases, open surgery may be the preferred option. Patients should discuss the potential risks and benefits of each approach with their surgeon to determine which option is most appropriate for their individual needs.

How long is the recovery time after minimally invasive hernia surgery?

Recovery time after minimally hernia surgery varies depending on several factors, including the size and location of the hernia and the patient’s overall health. In general, patients can return to normal activities within a week or two following the procedure.

However, strenuous activities, such as heavy lifting or exercise, should be avoided for at least six weeks to allow the incisions to heal properly. Patients may experience some discomfort, swelling, or soreness at the incision sites and in the abdomen in the days following the surgery, but this typically resolves within a few days to a week, and can be controlled with pain medicines.

Are recurrent inguinal hernias less likely after minimally invasive inguinal hernia repair compared to traditional surgery?

Recurrence rates after repair of inguinal hernias depend on several factors, including the type of surgery performed, the surgeon’s experience, and the patient’s overall health. Studies have shown that laparoscopic or robotic inguinal hernia repair have similar recurrence rates compared to traditional open surgery, but they allow for a faster recovery and less pain.

Laparoscopic or robotic inguinal hernia surgery allows for a larger field of vision and placement of a largery mesh and reduces the risk of damaging the surrounding tissue. However, recurrent hernias are still possible after minimally invasive surgery, and patients should follow their surgeon’s postoperative instructions carefully to reduce their risk of hernia recurrence.

Can a femoral hernia be repaired laparoscopically or robotically?

A femoral hernia repair surgery is preferably repaired laparoscopically or robotically. Your surgeon will determine if minimally invasive or open hernia repair is the best type of repair surgery for your femoral hernia.

Laparoscopic or robotic hernia repair is a minimally invasive approach to treating hernias that offers several advantages over traditional open surgery. Minimally invasive techniques are safe, effective, and associated with a shorter recovery time, reduced scarring, and a lower risk of postoperative complications. If you have a hernia, talk to your doctor to determine whether laparoscopic or robotic hernia repair is a suitable treatment option for you.

The Iskandar Complex Hernia Center offers complex hernia surgery and advanced abdominal procedures with unmatched compassion and skill so that you can experience a significantly enhanced quality of life. Dr. Iskandar takes a non-judgmental, listen-first approach with his patients and provides minimally invasive surgery for optimal recovery. To schedule your appointment, call The Iskandar Complex Hernia Center or visit the website for more information.

Posted on April 5, 2023

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Dr. Iskandar, MD, FACS is a board-certified general surgeon with fellowship training in minimally invasive surgery and bariatric surgery. He is an accredited Surgeons of Excellence in Hernia Surgery by the SRC. The Iskandar Complex Hernia Center is one of only two North Texas Hernia Centers deemed Centers of Excellence. As a globally respected complex hernia expert, he specializes in complex hernia repair and abdominal reconstruction. He is also an Associate Professor of Surgery at Texas A&M School of Medicine.