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Today's Medicine

Minimally Invasive Hernia Surgery: Laparoscopic and Robotic Techniques Offer Numerous Benefits

Published: July 1, 2021

The mention of the word hernia is enough to make some people wince or groan in discomfort. Hernias are fairly common and treatable, though, with more than 1 million repair procedures performed each year in the U.S. 

Hernia patients at Methodist can be confident knowing that our surgical teams are skilled using several techniques to repair multiple types of hernias.

 

What Is a Hernia?

A hernia is a defect within the fascia (the tough tissue around muscle layers) that fat or organs can protrude through. Hernias can be present at birth but are more commonly the result of pressure from things like physical strain, chronic coughing or sneezing, pregnancy, obesity, or strain during defecation or urination. 

Common types of hernias are:

Inguinal: This type of hernia occurs in the groin area. It’s the most common type and more often affects men.

Femoral: These hernias are relatively uncommon but happen more often in females. They occur in the upper medial thigh and can be difficult to diagnose.  

Hiatal: This condition is more common for adults over age 50 and involves the upper part of the stomach bulging through the diaphragm.   

Incisional: As the name implies, these hernias are possible after abdominal surgery.

Ventral: This type of hernia occurs through an opening in the abdominal muscles.

Umbilical: These hernias can be present at or near the belly button. They’re common in infants and often resolve over time.

 

Hernia Symptoms

The more common inguinal and femoral hernias can have symptoms that include:

  • A lump or bulge
  • Pain, aching, swelling or soreness in the area of the bulge
  • Pain during lifting or straining
  • Discomfort, weakness or pressure in the groin

Not all hernias cause pain or discomfort, but with the exception of infant umbilical hernias, they don’t resolve on their own. Left untreated, hernias can grow and lead to other issues such as the intestine becoming stuck in the inguinal canal or even cut off from blood supply.

If you think you may have a hernia, it’s best to consult your primary care provider. They can help determine how serious your condition is. In some cases, continually monitoring a hernia is the best course of action. But you may also be referred to a general surgeon trained to know if you need surgical repair and what type of surgery is best for your situation. 

 

Types of Hernia Repair

With hernias being so common, Methodist’s skilled surgeons have extensive training and experience repairing them.

Surgical hernia treatments involve making an incision or incisions, returning protruding tissue to where it belongs, then repairing and strengthening the weakened area with stitches and sometimes synthetic mesh.

Surgical options are:

Open surgery: This traditional method of hernia repair involves a larger incision near the affected area before repair work begins. This approach is safe and effective, but it can result in significant discomfort and longer recovery – sometimes as long as six weeks – before you can fully resume all of your normal activities.

Laparoscopic surgery: In this minimally invasive approach, a surgeon uses much smaller incisions to access the affected area. They insert a laparoscope (a small instrument with a camera) through one incision and surgical tools in the others to perform the repair. Patients undergoing this procedure generally experience less pain and smaller scars after surgery, can resume light activities within a week or two, and are usually cleared for strenuous activity within a month.  

Robotic surgery: This method essentially is laparoscopic surgery, but instead of the surgeon directly performing the procedure, they are controlling a robot handling the surgical tools. This can lead to even greater surgical precision and the same or enhanced benefits patients experience with traditional laparoscopic surgery.

Which surgery is right for you? Several factors help our team decide the most appropriate approach. They include:

  • If a hernia is incarcerated – when tissue can’t be easily returned to its proper place
  • If a hernia is strangulated – when blood flow is cut off to the affected area
  • Scar tissue from previous operations, making minimally invasive approaches unfeasible
  • The size of the hernia

An ultrasound or CT scan may also assist our team with surgical planning. In many cases, we can schedule your hernia repair for the same day as your initial office visit.


Benefits of Minimally Invasive Approaches

Whenever possible, we want to use a minimally invasive approach. The benefits of such procedures include:

  • Smaller incisions, generally resulting in less pain
  • Lower risk for wound complications
  • More precise placement of surgical mesh
  • Reduced need for opioid pain medications
  • Shorter hospitalizations
  • Smaller and less scarring

 

After Surgery

Typically, patients undergoing small hernia repairs can return home the same day, as less invasive options typically lead to faster recoveries with fewer complications. Larger hernias may require an overnight stay or several days in the hospital if an open surgery is necessary.

Regardless of which procedure you have, you can expect several weeks of recovery and some degree of pain. You’ll need at least one follow-up appointment with our team in the weeks following your surgery, but know that our door is always open if you have questions or are experiencing complications.

 

A Team You Can Trust

Having a hernia can be a scary, but don’t let worry or uncertainty keep you from seeking help. And if you do need surgery, rest assured that our team is committed to combining the latest technology with The Meaning of Care to resolve your issue and get you on track to improving your quality of life.

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About the Author

Dr. Ben Grams is a surgeon with Methodist Physicians Clinic. His medical interests include laparoscopic and robotic hernia repair.

“I will go the extra mile to help make you comfortable every step of the way,” he said. “I will not only be your surgeon but also your teammate and partner through the preoperative, operative and postoperative care you need.”

See more articles from Ben Grams, MD
Dr. Ben Grams, general surgeon