Although laparoscopy is a more modern and less invasive technique than traditional surgery, many patients are still operated on in accordance with the traditional surgical route, i.e. through an anterior approach. We discuss this topic with Dr. Stefano Bona, Head of the General Surgery and Day Surgery Section of the Operating Unit of General and Digestive Surgery at Humanitas.
In the case of inguinal hernia, traditional anterior surgery is still the first choice in surgical route in most cases – explains the expert – although both techniques allow identifying and repositioning the hernia using shaped nets made of synthetic and biocompatible material, which are fixed to muscles and tendons in order to strengthen the abdominal wall. While with traditional surgery this happens through a small cutaneous incision made at the groin level and requires a local anesthesia with a discharge usually during the same day, laparoscopy provides for three small holes at the level of navel and general anesthesia, which can allow same day discharge only in certain cases.
When is laparoscopy recommended?
The surgeon chooses traditional anterior or more modern laparoscopy surgery on the basis of various factors, including hernia and patient characteristics. Laparoscopy can offer more advantages than traditional surgery in the case of:
Bilateral inguinal hernias, i.e. when hernia is present both right and left at the same time, because it allows both hernias to be repaired in a single operation.
Recurrent inguinal hernia, occurs when the hernia reappears in the same place where it had already been treated. Laparoscopy is used to avoid the use of the previously used skin access and going back through the scar (and possibly the net) of the previous surgery.
However, the need to involve general anesthesia may make laparoscopy not advisable in elderly patients or in the presence of certain diseases. In addition, laparoscopy may also be difficult in patients who have undergone previous abdominal surgery because adhesions may be encountered.