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Laparoscopic Repair of Ventral and Incisional Hernia


Your doctor may recommend laparoscopic surgery to repair a ventral incisional hernia.

A ventral hernia can be seen as an abnormal bulge beneath the skin of your abdomen.

The bulge may be your intestines, which are located inside your abdomen.

A thin membrane, called the peritoneum, covers most of your abdominal organs, including your intestines.

Your abdominal muscles surround the peritoneum, and your skin covers the abdominal wall. These three layers cushion and protect your internal organs.

If you have had abdominal surgery in the past, a ventral incisional hernia may appear at the site of your surgical scar.

Here your intestine pushes through a weakened spot in the tissue between your abdominal muscles, creating a bulge beneath your skin.

The peritoneal tissue surrounding the herniated intestine is called the hernia sac.

If your hernia is not repaired, complications may occur.

For example, the hernia opening may trap a loop of your intestine, which can partially or completely block passage of its contents, resulting in a condition called intestinal obstruction.

Symptoms such as pain, vomiting, and constipation may occur.

Intestinal obstruction may cause strangulation, a condition in which blood flow is cut off to your intestine. As a result, a segment of your intestine may die.

Before your procedure, an intravenous line will be started, and you may be given a sedative to help you relax.

You will be given general anesthesia, which will put you to sleep for the duration of the operation.

A breathing tube will be temporarily inserted through your mouth and into your throat to help you breathe during the operation.

A catheter may also be placed in your bladder to drain your urine.

To begin the procedure, your surgeon will make a small incision in your abdomen.

Then place a small tube, called a port, into the incision.

Then your surgeon will pump carbon dioxide gas through the port into your abdomen, expanding it to allow him or her to see your abdominal organs more easily.

Next, your surgeon will make another incision near your umbilicus or belly button and insert another small port.

Through this port your surgeon will insert a laparoscope, which is a tiny camera that projects images onto a TV monitor to guide your surgeon's work.

While viewing the inner surface of your abdomen, your surgeon will make two more incisions and insert two more ports.

Next, your surgeon will insert narrow surgical instruments through these ports to begin the repair.

Scar tissue from previous operations will be removed, if necessary.

Then, your surgeon will cut away the hernia sac allowing your intestine to return to its proper location in your abdomen.

Next, your surgeon will suture a piece of mesh over the weak spot in the abdominal wall to prevent your intestine from slipping back through the opening.

Your surgeon will examine the area for bleeding or other damage and repair as necessary.

A port valve will be left in place briefly to allow all the carbon dioxide to escape from the abdomen.

Finally your surgeon will remove the instruments and close the incisions with sutures or staples.

After your procedure, the breathing tube and catheter will be removed and you will be taken to the recovery area for monitoring.

You will be given pain medication as needed.

When you are able to drink liquids, your intravenous line will be removed.

You may go home the same day or stay overnight in the hospital.

To aid the healing of your hernia, avoid heavy lifting, bending, and twisting for several weeks after your procedure.