Laparoscopic Ventral Hernia Repair
Laparoscopic surgery is performed using general anesthesia. The surgeon makes several small incisions in the abdomen and inserts a laparoscope-a thin tube with a tiny video camera attached to one end. The camera projects a magnified image of inside the abdomen to a monitor, giving the surgeon a close-up view of the hernia and surrounding tissue. While viewing the monitor, the surgeon uses instruments to carefully repair the hernia using synthetic mesh.
Patients who undergo laparoscopic surgery generally experience a somewhat shorter recovery time. However, the doctor may determine laparoscopic surgery is not the best option if the hernia is very large or if there is too much prior scar tissue to perform it safely laparoscopically.
Most adults experience discomfort after surgery and require pain medication. Vigorous activity and heavy lifting are limited for several weeks. The doctor will discuss when a person may safely return to work.
The UCSF Hernia Center provides the latest treatments for complex ventral hernias, such as the progressive pneumoperitoneum procedure, a specialized approach for treating particularly large ventral hernias. Our patient outcomes far surpass the national average. Patients with complex ventral hernias treated at UCSF have a recurrence rate of approximately 18 percent, compared to a 30 to 40 percent recurrence rate nationally.
Surgery to repair a ventral hernia is generally safe and complications are uncommon. Knowing possible risks allows patients to report postoperative symptoms to their doctor as soon as they occur.
Risk of general anesthesia. Before surgery, the anesthesiologist-a doctor who administers anesthesia-reviews the risks of anesthesia with the patient and asks about medical history and allergies to medications. Complications most likely occur in older people and those with other medical conditions. Common complications include nausea, vomiting, urinary retention, sore throat, and headache. More serious problems include heart attack, stroke, pneumonia, and blood clots in the legs.
Getting out of bed after surgery and moving as soon as the doctor allows will help reduce the risk of complications such as pneumonia and blood clots.
Hernia recurrence. A hernia can recur up to several years after repair. Recurrence is the most common complication of inguinal hernia repair, causing patients to undergo a second operation.
Bleeding. Bleeding inside the incision is another complication of inguinal hernia repair. It can cause severe swelling and bluish discoloration of the skin around the incision. Surgery may be necessary to open the incision and stop the bleeding. Bleeding is unusual and occurs in less than 2 percent of patients.
Wound infection. The risk of wound infection is small-less than 2 percent-and is more likely to occur in older adults and people who undergo more complex hernia repair.2 The person may experience a fever, discharge from the incision, and redness, swelling, or tenderness around the incision. Postoperative infection requires antibiotics and, occasionally, another procedure requiring local anesthesia to make a small opening in the incision and drain the infection.
Painful scar. Sometimes people experience sharp, tingling pain in a specific area near the incision after it has healed. The pain usually resolves with time. Medicine may be injected in the area if the pain continues.
Injury to internal organs. Although extremely rare, injury to the intestine, bladder, kidneys, nerves and blood vessels leading to the legs, internal female organs, and vas deferens-the tube that carries sperm-can occur during hernia surgery and may lead to more operations.
For More Information
Ventral Hernia Repair (American College of Surgeons)