Laparoscopic Repair for Inguinal (Groin) Hernia

Inguinal (Groin) HerniaApproximately 600,000 hernia repair operations are performed annually in the U.S. Many are performed by the conventional, or open, method. Some inguinal hernia repairs are performed using a small camera-like instrument known as a laparoscope.

What Is a Hernia?
A hernia occurs when the inside layers of the abdominal muscle have weakened, resulting in a bulge or tear. In the same way that an inner tube pushes through a damaged tire, the inner lining of the abdomen pushes through the weakened area of the abdominal wall to form a small balloon-like sac. This can allow a loop of intestine or abdominal tissue to push into the sac. The hernia can cause severe pain and other potentially serious problems that could require emergency surgery.

Both men and women can get a hernia. You may be born with a hernia (congenital) or develop one over time.

A hernia does not get better over time, nor will it go away by itself. Use of a truss (hernia belt) is rarely prescribed as it is usually ineffective.

How Do I Know If I Have an Inguinal Hernia?
The common areas where hernias occur are in the groin (inguinal), belly button (umbilical), and the site of a previous operation (incisional).

It is usually easy to recognize a hernia. You may notice a bulge under the skin. You may feel pain when you lift heavy objects, cough, strain during urination or bowel movements, or during prolonged standing or sitting. The pain may be sharp and immediate or a dull ache that gets worse toward the end of the day. Severe, continuous pain, redness, and tenderness are signs that the hernia may be entrapped or strangulated. These symptoms are cause for concern and immediate contact of your physician or surgeon.

What Causes a Hernia?
The wall of the abdomen has natural areas of potential weakness. Hernias can develop at these or other areas due to heavy strain on the abdominal wall, aging, injury, an old incision or a weakness present from birth. Anyone can develop a hernia at any age. Most hernias in children are congenital. In adults, a natural weakness or strain from heavy lifting, persistent coughing, and difficulty with bowel movements or urination can cause the abdominal wall to weaken or separate.

What Are the Advantages of Laparoscopic Hernia Repair?
Laparoscopic Hernia Repair is a technique to fix tears in the abdominal wall (muscle) using small incisions, telescopes and a patch (mesh). If may offer a quicker return to work and normal activities with a decreased pain for some patients.

Are You a Candidate for Laparoscopic Hernia Repair?
Only after a thorough examination can your surgeon determine whether laparoscopic hernia repair is right for you. The procedure may not be best for some patients who have had previous abdominal surgery or who have underlying medical conditions.

How Is Hernia Repair Performed?
Most hernias require a surgical procedure, which may be done in one of two fashions.

The open approach is done from the outside through a 3- to 4-inch incision in the groin or the area of the hernia. The incision will extend through the skin and subcutaneous fat, allowing the surgeon to get to the level of the defect. The surgeon may choose to use a small piece of surgical mesh to repair the defect or hole. This technique is usually done with a local anesthetic and sedation but may be performed using a spinal or general anesthetic.

In laparoscopic hernia repair, a fiber optic camera attached to a special instrument is inserted through a small hollow tube, allowing the surgeon to view the hernia and surrounding tissue on a video screen.

Other cannulas are inserted that allow your surgeon to work inside the body without major incisions; three or four quarter-inch incisions are usually all that is necessary. The hernia is repaired from behind the abdominal wall. A small piece of surgical mesh is placed over the defect and held in place with small surgical staples. This operation is usually performed with general anesthesia or occasionally using regional or spinal anesthesia.

General Surgeon Kevin Miller, M.D.
Dr. Miller is on staff at King’s Daughters Medical Center and King’s Daughters Medical Center Ohio, performing both both traditional (open) surgical procedures and minimally invasive procedures, such as laparoscopic hernia repair. Additionally, Dr. Miller is trained in the use of the DaVinci robotic surgical system. A graduate of the University of Kentucky School of Medicine, Dr. Miller is board certified by the American Board of Surgery.

New patients, referrals and second-opinion consults are welcome. Please call (606) 324-2600 for more information.

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