Laparoscopic surgery is when the operation is carried out with miniature instruments, including an illuminated tube with fibre optic visual system. It is a relatively recent innovation in hernia repair and should only be performed by  specialists in Laparoscopy. Before you make your decision, find out if your surgeon has a record of success in performing this type of operation.

The advantages of Laparoscopic surgery
Having your hernia repaired laporoscopically has a number of advantages over the traditional open operation:

• smaller incisions, reduce pain and speed recovery.
• less pain and therefore less pain medication.
• hospital stay is reduced - often with a same day discharge.
• reduced risk of infection.  

The disadvantages of Laparoscopic surgery
There are two different laparoscopic approaches: TAPP (trans abdominal preperitoneal approach) and TEP (total extraperitoneal approach). In the latter, the operation can be completed without the need to enter the abdominal cavity and this is the preferred method at the London Hernia Clinic.

With a TAPP Laparoscopic operation there is a  slightly higher risk of injury to major vessels and the bowel (4.7 per 1000 at laparoscopic operations as opposed to 1.1 per 1000 at open operations). The TEP approach involves no greater risks than open surgery.

Is it right for me?
The decision on whether to have open or laparoscopic hernia repair will depend on a number of factors. An open operation is usually preferred in the following cases:

• A laparoscopic repair requires a general anaesthetic. So if you do not want to be put to sleep for your operation, you will have to have your hernia repaired under local or regional anaesthetic as an open procedure.
• Small umbilical or paraumbilical hernias can often be repaired using a small cut within or just below the “belly button” - it therefore makes sense to have an open operation.
• Epigastric hernias should also be repaired at open operation since the defect cannot be seen from inside the abdominal cavity. 
• If the wound over the incisional hernia is unsightly and needs to be removed then it is better to offer an open operation.

For all other incisional hernias, larger umbilical or paraumbilical hernias and inguinal hernias, a laparoscopic repair should certainly be considered. Ultimately, when you come to the London Hernia Clinic the decision is yours. If you need any more advice or information call 020 7935 1210 or click here to book an appointment.

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