Keyhole surgery : A guide to Hernias

This is also known as ‘laparoscopic’ surgery: a series of small incisions are made and a small camera mounted tube is inserted into the abdomen to help guide the surgeon. This camera projects an image of the hernia onto a large screen which is used as a guide during the procedure.

The advantage of this surgery compared to open hernia surgery is that only small incisions are made which results in a quicker recovery time and less pain for the patient.

But this is a highly skilled procedure which should only be performed by an experienced surgery. An inexperienced surgeon runs the risk of causing damage to tissues surrounding the hernia due to the fact that they have less control than with open surgery.

This surgery is also carried out under a general anaesthetic compared to open surgery which can be performed using a local anaesthetic.

If you are choosing to have private treatment then ensure that your surgeon is skilled and experienced in keyhole surgery for hernia repair.

Before keyhole surgery

The preparations for these are similar to those for open hernia surgery. They include undergoing tests such as an ECG, stopping smoking (if you are a smoker), booking time off work with your employer and planning your recovery when you return home.

The open hernia surgery section contains more information about this.

Keyhole surgery day

This will be similar to that for open hernia surgery. If you are choosing to pay for private treatment then you will be asked to pay for your treatment – if you have not done so already.

You will be asked to sign a consent form and to change into a theatre gown.

Keyhole surgery can be performed under a local anaesthetic but it is still a good idea to ask someone to drive you home after the surgery. You will be tired and sore following this procedure so arrange for your partner or a friend to do so.

The hernia keyhole surgery procedure

This involves the surgeon making a series of two to three small incisions in the abdomen. He or she will then insert a variety of surgical instruments into these incisions which include a slim tube with a camera mounted at one end. This enables the surgeon to view the hernia and the procedure on a large video screen.

The hernia will be put back into place and the weak spot in the abdominal wall will be stitched and covered with surgical mesh. This adds extra support to the abdominal wall.

These incisions are closed with a series of dissolvable stitches and a surgical dressing is applied to the area.

After keyhole surgery

If you have had a local anaesthetic then you will be returned to your room or ward. If you were given a general anaesthetic then you will be taken to a recovery room where your condition will be monitored. Once the medical staff are satisfied with your condition you will then be returned to your ward/room.

Some people find that they feel nauseous after a general anaesthetic. If you do experience this then the staff will give you something to deal with this.

After 24 hours, the surgical wound will have sealed which means that the dressing will be removed. You are then able to have a bath or shower.

Once you are home, make sure you take in plenty of fluids and eat foods which are high in fibre, for example wholemeal bread, fresh fruit etc. This is to aid with bowel movements (avoiding any unnecessary straining on your wound) and to prevent constipation. If you find that you are unable to move your bowels then speak to your GP.

Gradually resume your normal daily activities (which include sexual relations) but avoid any unnecessary stresses and strains on your surgical wound. Avoid playing sport for the first couple of weeks after surgery but check with your surgeon/GP as to when you are safe to do so. This is particularly important if you lift weights as part of your sport.

If you have a desk job then you will be able to return to this after two to three weeks. But allow another week or two if your job is manual or involves heavy lifting.

Recovery is quicker from keyhole surgery than open hernia surgery.

Complications of hernia keyhole surgery

Surgery is very safe but no procedure is 100% free from side effects and complications. The main risks are:

• Recurring hernia (hernia comes back again)
• Bruising and swelling
• Haematoma (bleeding under the skin)
• Infection (you may be given antibiotics to prevent this)
• Discharge from the surgical wound
• High temperature
• Nausea and/or vomiting
• Blood clots

As with open hernia surgery: if you experience any excessive bleeding, severe pain or any other unexpected symptom then contact your GP or surgeon.

Whichever surgical procedure you choose it is worth bearing in mind that there is a small risk of recurrence. In other words, the hernia comes back.

But the vast majority of hernia surgeries result in a permanent solution with recurrence occurring in fewer than 5% of cases. If this does occur then it is likely to affect older people or those in poor health.