You may have heard ‘laparoscopic hernia repair’ referred to as ‘keyhole’ hernia surgery, which involves using cameras to view the surgical area. This approach can only be done under general anaesthesia. You may also have heard that the scars from laparoscopic surgery are much smaller than open surgery. It is true that the area of skin cut is smaller than in open surgery, but the area of tissue dissection is much larger when carrying out keyhole hernia surgery than in open surgery.
Body shape is an important factor in deciding the approach to use. Fatty tissue makes the surgery more difficult and increases the risks of laparoscopic surgery. As a rough rule of thumb, your BMI needs to be less than 28 for a laparoscopic repair.
Our Consultant Surgeon is highly experienced with both approaches to laparoscopic hernia repair. During your consultation he will discuss and guide you through deciding on a bespoke treatment plan.
While we often recommend our innovative Local Anaesthetic and Sedation approach, there are some cases when a laparoscopic approach is better for a particular patient or hernias.
Bilateral Hernias
Laparoscopic repairs may be preferable if you have bilateral hernias – two hernias that need repair at the same time, but this is only the case for certain patients. Many bilateral inguinal hernias are best treated using our staged open repair approach.
Recurrent Hernias
If you have previously had open hernia surgery, it is usually better to repair the recurrent hernia using a laparoscopic approach, and vice versa.
Changing the approach from a previous mesh repair can improve the chances of success.
Larger Hernias
Particularly large hernias may also need general anaesthesia using an open approach. Laparoscopic repair is not usually suitable for larger hernias.
While keyhole hernia repair might be suitable for your circumstance, it is important to understand that it can result in complications not seen with open surgery. For example, while rare, patients might experience bleeding, a bowel injury or a bladder injury and require a catheter for a limited period.
Our highly experienced Consultant Surgeon will help you understand these risks in more detail during your consultation.
Typically, recovery from laparoscopic hernia surgery is not quicker than after an open repair using local anaesthetic and sedation. Our friendly team is here to support you through your recovery. We provide invaluable advice with our rehab programme on how to improve your recovery.
It is important to be aware that:
1. Surgery causes a certain amount of tissue damage, which needs time to heal. Laparoscopic hernia repair does not lead to an immediate return to activity.
2. You will need pain relief, taken as advised in our post-surgery leaflet: regular Paracetamol and Ibuprofen initially, with Dihydrocodeine as a top-up when needed.
3. Bruising after laparoscopic surgery is less colourful than open groin surgery, but fluid still travels down to the most gravity dependant part (the scrotum) which swells and becomes bruised to varying degrees. Any swelling or bruising should resolve after 2 weeks.
4. Skin sensation changes are much less common than with open repair, with very few patients experiencing this.
5. The risk of urine retention is greater for higher-risk patients, specifically with older patients or those with a known prostate problem. Urine retention is treated with a urinary catheter for up to a week.
6. It is important to keep mobile. Advice on returning to activity is described on our post-surgery advice page. Bruising stabilises from 48 hours post-surgery. Keep wearing your TED stockings until you have good mobility and are walking around the house and garden.
7. Hernia pants are helpful after laparoscopic repairs. Hernia pants help protect the abdominal wall as it heals, and make mobility more comfortable early on by providing support and reassurance. We recommend patients wear hernia pants for as long as they are helpful and when initially returning to exercise and more physical activities.
See our Post-Surgery Advice page for more information
Check out more information on why we recommend hernia supports as well as our dedicated Post Hernia Surgery Rehabilitation Exercise Programme
The cost of a Laparoscopic Hernia Operation can vary depending on your particular hernia. We will work with you to come up with the best treatment plan, and all of our hernia surgery packages are all-inclusive and competitively priced.
Examples include:
Laparoscopic Recurrent Inguinal Hernia Surgery under general anaesthetic from: £4,400
Bilateral Keyhole Inguinal Hernia Surgery under general anaesthetic: from £5,700