Hernia Surgery Options After Previous Laparoscopic Procedures

Inquiry about hernia surgery?

Hello, doctor: Recently, I have noticed a bulge in my lower right abdomen, and after examination, it has been confirmed as a hernia.
I am considering surgical treatment for it, but I have previously undergone two laparoscopic surgeries (cholecystectomy and appendectomy).

1.
Can I still choose laparoscopic surgery for my hernia repair, or is traditional open surgery the only option available?
2.
If I opt for "totally extraperitoneal laparoscopic hernia repair," can any surgeon who performs laparoscopic (minimally invasive) hernia surgeries do the procedure, or should I specifically seek out a surgeon who has experience with "totally extraperitoneal laparoscopic hernia repair"?

Mr. Li, 50~59 year old female. Ask Date: 2023/03/03

Dr. Chen Ronghong reply Surgery

Hello Mr.
Li,
1.
Laparoscopic appendectomy may present some increased surgical difficulty due to the overlapping location of the abdominal wall incision with that of the laparoscopic extraperitoneal hernia repair; however, laparoscopic surgery remains a viable option.

2.
Laparoscopic hernia repair can be performed using either the extraperitoneal or intraperitoneal approach.
You can inquire about which method the minimally invasive surgeon will be using during your consultation.

Reply Date: 2023/03/03

More Info

When considering hernia surgery options after previous laparoscopic procedures, it's essential to understand the implications of your surgical history and the available techniques.
1. Can I still opt for laparoscopic surgery for my hernia?
Yes, in many cases, you can still choose laparoscopic surgery for hernia repair, even after having undergone previous laparoscopic procedures such as cholecystectomy (gallbladder removal) and appendectomy. However, the decision will depend on several factors, including the type and size of the hernia, your overall health, and the specifics of your previous surgeries. Laparoscopic hernia repair is a minimally invasive technique that typically results in less postoperative pain, quicker recovery, and smaller scars compared to traditional open surgery. However, if there are significant adhesions or complications from your previous surgeries, your surgeon may recommend an open approach instead.

2. Is it necessary to find a surgeon experienced in "totally extraperitoneal laparoscopic hernia repair"?
While many surgeons are trained in laparoscopic techniques, not all may be proficient in specific methods like the totally extraperitoneal (TEP) approach. It is advisable to seek a surgeon who has experience with this particular technique, especially if you have had previous abdominal surgeries. The TEP approach involves accessing the space outside the peritoneum (the lining of the abdominal cavity) to repair the hernia, which can be beneficial in patients with a history of abdominal surgery due to potentially reduced risk of complications related to adhesions.

Additional Considerations:
- Risks and Benefits: Each surgical option has its risks and benefits. Laparoscopic surgery generally has a lower risk of infection and a shorter recovery time, but it may not be suitable for everyone. Open surgery might be necessary if there are complications from previous surgeries, such as extensive scar tissue.

- Preoperative Assessment: Before proceeding with surgery, a thorough preoperative assessment is crucial. This may include imaging studies to evaluate the hernia and any potential complications from previous surgeries. Discussing your medical history in detail with your surgeon will help them tailor the best approach for your situation.

- Postoperative Care: Regardless of the surgical method chosen, postoperative care is vital. Follow your surgeon's advice on activity restrictions, pain management, and signs of complications to ensure a smooth recovery.

- Long-term Outlook: Most patients experience significant relief from symptoms and a return to normal activities after hernia repair. However, it's essential to maintain a healthy lifestyle and avoid activities that could strain the surgical site to minimize the risk of recurrence.

In conclusion, while you may still have options for laparoscopic hernia repair, the choice of technique should be made in consultation with a qualified surgeon who understands your unique medical history and the specifics of your previous surgeries. This collaborative approach will help ensure the best possible outcome for your hernia repair.

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