Laparoscopic Hernia Surgery

What Is Laparoscopic Hernia Surgery?

Laparoscopic hernia surgery basically uses a minimally invasive technique to perform a hernia repair. It involves making small incisions around the treatment site, through which specialised instruments and a laparoscope (a long, flexible tube attached to a light and camera at the end) are inserted.

Unlike traditional surgery, which often requires a long incision to access the treatment site, laparoscopic surgery only requires small keyhole incisions. This results in less scarring, less post-surgical pain, and a quicker recovery period.

When Is Laparoscopic Hernia Repair Recommended?

Laparoscopic hernia repair is recommended for various types of hernias and patient conditions. It is commonly recommended for the following scenarios:

• Inguinal Hernia (Groin Hernia): Laparoscopic repair is recommended for patients with bilateral inguinal hernias or those experiencing recurrence after previous open surgery. This approach facilitates simultaneous repair through smaller incisions, reducing post-operative pain and promoting faster recovery. It also minimises tissue trauma in recurrent cases, potentially preventing further complications.
• Ventral Hernia (Umbilical or Epigastric Hernia): Laparoscopic surgery is preferred for small to moderate-sized ventral hernias. The technique offers benefits such as reduced post-operative discomfort, quicker return to normal activities, and effective mesh reinforcement of the weakened abdominal wall.
• Femoral Hernia: Laparoscopic repair provides comprehensive visualisation and access to the groin area, leading to improved surgical outcomes. The enhanced visibility allows for more precise repairs and reduces the risk of complications.
• Incisional Hernia: For small to moderate-sized incisional hernias—especially in the absence of significant adhesions or complications from prior surgeries—laparoscopic repair is recommended. It helps minimise additional disruption to the abdominal wall, lowers the risk of wound complications, and supports quicker recovery.
• High-Risk Patients: Given the increased risk of complications associated with open surgery in patients with obesity or chronic medical conditions, laparoscopic hernia repair is often preferred. Its minimally invasive nature, smaller incisions, and faster recovery make it a safer option for these patients.

Who Is Eligible for Laparoscopic Hernia Surgery?

One’s suitability for laparoscopic hernia surgery is determined by several factors – the patient's overall health, the size and location of the hernia, and the surgeon's expertise. Generally, laparoscopic hernia surgery is recommended for patients with smaller and less complex hernias.

This approach may not be suitable for patients with large and complicated hernias, which may require a larger area for the surgeon to manoeuvre around; or those with extensive scar tissue or irregularities in the abdominal wall.

The Laparoscopic Hernia Surgery Procedure

Laparoscopic hernia surgeries are performed under general anaesthesia. The surgeon makes three to four small incisions to access the hernia. The abdomen may be gently inflated with gas in order to allow for ample space for the surgeon to operate with minimal obstruction.

A small scope attached to a camera (laparoscope) is inserted into one incision, allowing the surgeon to view the hernia and surrounding structures on a screen. Using the live video feed as guidance, the surgeon inserts small surgical instruments through the other incisions in order to repair the hernia. In some cases, a synthetic mesh will be placed to act as a support structure, preventing the hernia from recurring.

Once the hernia is repaired and the mesh is securely in place, the surgeon carefully removes the laparoscope and instruments used during the procedure. The small incisions are closed using sutures or surgical glue. The procedure typically takes 30 minutes for simple repairs and up to five hours for more complex repairs.

What Are the Benefits of Laparoscopic Hernia Surgery?

In suitable cases, laparoscopic hernia surgery offers numerous benefits over traditional open surgery. These benefits include:

• Smaller Incisions: The procedure uses several tiny incisions (typically 0.5–1 cm) instead of one large cut.
• Reduced Scarring: Smaller incisions naturally lead to less noticeable scars.
• Less Pain: Smaller incisions result in less tissue damage, leading to less post-operative pain.
• Lower Risk of Infection: Smaller wounds and reduced exposure of internal tissues help lower the likelihood of infection during healing.
• Shorter Hospital Stay: Many laparoscopic procedures are done on a day-surgery basis or with an overnight stay, allowing for a quicker return home.
• Faster Recovery: Patients experience a shorter recovery period, allowing them to resume their regular activities sooner.

What Is Recovery Like?

After surgery, patients will be monitored in the recovery room until the anaesthesia wears off. Many patients can go home the same day once they are stable. Over the first few days, some swelling, nausea, and mild pain are common. These side effects are usually manageable and may subside within a few days.

Patients can gradually return to work depending on their job type. Full recovery may take several weeks to a few months. However, maintaining lifestyle changes is still important to prevent hernia recurrence.

Is Laparoscopic Hernia Surgery Safe?

Laparoscopic hernia surgery is generally considered safe and effective with complications being rare. As with any surgical procedure, however, some risks are involved, such as infection, bleeding, and damage to nearby organs.

In the hands of an experienced laparoscopic hernia surgeon, these risks will be properly managed to ensure maximum safety throughout and even after the procedure is completed.

Ultimately, the benefits of reduced pain, reduced risk of complications, and a quicker recovery often outweigh these unlikely risks among eligible patients.

Why Choose Us for Laparoscopic Hernia Surgery

Dr Wong Jen San is a skilled Consultant Hepatobiliary and Pancreatic Surgeon with over 15 years of experience treating hernias, including the use of minimally invasive (laparoscopic) techniques for hernia repair. Dr Wong received his medical training in the UK, and completed a rigorous fellowship training at various established medical centres in Japan.

He previously served as a Consultant at the Department of Hepatopancreatobiliary (HPB) and Transplant Surgery at the Singapore General Hospital, an Adjunct Assistant Professor at Duke-NUS Graduate Medical School, and a Visiting Consultant at the Department of Surgical Oncology at the National Cancer Centre (Singapore).

Laparoscopic Surgery for Hernia Repair FAQs