Laparoscopic inguinal hernia surgery
When, after diagnosis, I propose to a patient to operate on his inguinal hernia laparoscopically, it is natural that I am bombarded with questions.
Indeed, inguinal hernias can be operated under local anaesthesiawith relatively simple, largely standardised and highly effective techniques.
However, there are many considerations in favour of laparoscopic inguinal hernia repair, that lead the way in the choice of technique.
The first comes from very far back; from 1647 even, the year in which the French physicist and mathematician Blaise Pascal discovered his famous law.
Applied to hernia surgery, the Pascal's law tells us that when the mesh we use to repair a hernia is placed on the internal surface of the area of the herniated defect, it is the same pressure present inside the abdomen that anchors it to the abdominal wall; whereas if we place it on the external surface, the pressure tends to make it detach.
Another important reason is that by operating alaparoscopic inguinal hernia we can diagnose the possible presence of other wall defectsoften present in these patients and not looked for or not seen by the examiner - such as, for example, an umbilical hernia or a contralateral inguinal hernia, i.e. on the other side, a crural hernia - and repair them during the same operation.
Third reason, equally central: the intervention of laparoscopic inguinal hernia cause much less postoperative pain compared to surgery performed by traditional means.
In addition, many (most) of the surgeons who operate openly are in the habit of using 'plugs'These are sort of plastic 'plugs' that are inserted into the inner inguinal ring in order to reduce its size. Bad habit, because these plugs have a nasty tendency to migrateoften ending up inside the abdominal cavity and causing adhesions with the intestinal loops, which, in the most serious cases, can end up being injured by these plastic masses, up to the intestinal perforation.
In the photograph above, this is what we found in one of our last surgeries: a plug that had entered the abdominal cavity, causing severe adhesions with peritoneal fat and intestinal loops. And it wasn't the first volta.
Remember: if you are about to be operated on for ainguinal herniaask the surgeon if he intends to use a plug; if he says yes, think about it!
So, to sum up:
Here are the reasons - and not are few! - to propose the intervention of laparoscopic inguinal hernia repair. Add to this the fact that, for years now, the scientific community of surgeons dealing with the abdominal wall has established that laparoscopic inguinal hernia surgery represents the "gold standard for the treatment of this frequent, annoying and sometimes very serious condition.
However, probably following ingrained habits that make open inguinal hernioplasty a surgery that can be performed by any surgeon, even those who are not particularly specialised in abdominal wall surgery, and also because laparoscopic inguinal hernia surgery is by no means simple, but involves a long and arduous learning curve, today the vast majority of surgeons do not undertake laparoscopic inguinal hernia surgery. Obviously, to the great detriment of the patient.
Laparoscopic inguinal hernia surgery in my centre
For years I have been working to make my Centre, the Santa Caterina da Siena Clinic, Turin, a Centre of Excellence for the Treatment of Abdominal Wall Diseasesparticularly insisting on the minimally invasive laparoscopic surgery. I introduced, first in Europe, the Endoscopic rectus abdominis diastasis surgery (of which I now hold the world's largest case history) and, first in the world, the endoscopic surgery of large laparoceleswith an original technique derived from the Carbonell-Bonafé technique, also with preoperative preparation with botulinum toxin and progressive pneumoperitoneum for the reconstruction of the space in the abdominal cavity (techniques well known and widely used abroad, but practically unknown in Italy; in this too, excuse my lack of modesty, I was the first to arrive...). Continuing along the path of offering the patient the best possible therapeutic choices, and in line with international recommendations, I have decided to propose laparoscopic inguinal hernia repair to all my patients. Operationally, for the patient this entails a general anaesthesia instead of local anaesthesia, and a night of hospitalisation.
How does the surgery take place? You can take a look at the video below to understand the basic surgical steps for repairing thelaparoscopic inguinal hernia.
How to get enrolled for this surgery? Just fix a appointment or a video consultation.
Otherwise, you can contact me using the form below:
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