For inguinal (or groin) hernias:
In certain instances, a laparoscopic (or minimally invasive) approach to repair an inguinal hernia is desired. Although the laparoscopic approach requires a general anesthetic, certain patients may find benefit in this minimally invasive approach. In general, patients who are younger than age 45, who have hernias on both sides, and who present with a recurrent hernia are the best candidates for the laparoscopic approach. Patients undergoing the laparoscopic approach appear to have a shorter recovery period, more rapid return to work and less complications of long-term pain. Patients who are over the age of 60, however, appear to do very well with the open repair, even with bilateral repairs, and can avoid the added risks of a general anesthetic. Age appears to be a very important factor determining how much pain a patient will have after surgery in both the short-term and the long-term. Up to 20% of patients can have chronic groin pain, which appears to be “mesh pain”, and this appears to be more common in the younger patients. Patients who are between the ages of 45 and 60 are in the grey area regarding which approach would be better. The ultimate decision regarding which approach to pursue will be a decision made by you and your surgeon based on the risks and benefits of each.
Laparoscopic Incisional Hernia:
Incisional hernias are one of the more common complications of any surgical procedure of the abdomen. These hernias occur because the area of a surgical incision weakens under the strain of the abdomen. Patients who carry much of their weight in their mid-section or who have had multiple surgeries are at greatest risk for hernia development. Repairing incisional hernias laparoscopically appears to be the better way to approach these types of hernias. Not only can the hernia be fixed through several small incisions without reopening the original incision but additional areas of weakness along the abdominal wall can be identified and repaired at the same time, preventing a future hernia from developing that will later require surgery. The risks of infection and recurrence with the laparoscopic incisional hernia repair appear to be much lower than with the open approach.