| Hernia repair | |
|---|---|
 Surgical incision at the groin after inguinal herniorrhaphy | |
| Specialty | General surgery |
| Types | Herniorrhaphy, hernioplasty |
Hernia repair is asurgical operation for the correction of ahernia—a bulging ofinternal organs ortissues through thewall that contains it. It can be of two different types:herniorrhaphy; orhernioplasty.[1] This operation may be performed to correct hernias of theabdomen,groin,diaphragm,brain, or atthe site of a previous operation. Hernia repair is often performed as anambulatory procedure.
The first differentiating factor in hernia repair is whether the surgery is done open, or laparoscopically. Open hernia repair is when an incision is made in the skin directly over the hernia. Laparoscopic hernia repair is when minimally invasive cameras and equipment are used and the hernia is repaired with only small incisions adjacent to the hernia. These techniques are similar to the techniques used in laparoscopic gallbladder surgery.[citation needed]
An operation in which the hernia sac is removed without any repair of theinguinal canal is described as a herniotomy. When herniotomy is combined with a reinforced repair of the posterior inguinal canal wall withautogenous (patient's own tissue) orheterogeneous material such asprolene mesh, it is termed hernioplasty as opposed to herniorrhaphy, in which no autogenous or heterogeneous material is used for reinforcement.[citation needed]
The Stoppa procedure is atension-free type of hernia repair. It is performed by wrapping the lower part of theparietal peritoneum withprosthetic mesh and placing it at apreperitoneal level over Fruchaud's myopectinealorifice. It was first described in 1975 by Rene Stoppa.[2] This operation is also known as "giant prosthetic reinforcement of thevisceralsac" (GPRVS).[3]
This technique has met particular success in the repair of bilateral hernias, largescrotal hernias, and recurrent or rerecurrent hernias in which conventional repair is difficult and which carries a highmorbidity and failure rate.[4] The most recent reported recurrence rate (involving 230 patients with 420 hernias and a maximum of 8 years follow-up) was 0.71%.[5] The totally extra-peritoneal repair (TEP) uses exactly the same principles as the Stoppa repair, except that it is performedlaparoscopically.[6]
Robotic-assisted hernia repair has gained popularity due to its precision, smaller incisions, and quicker recovery times. Using robotic systems, surgeons have greater flexibility and control during the procedure. Although its use is still more expensive and requires specialized equipment, early studies suggest that robotic hernia repair may offer improved outcomes in complex cases, such as large or recurrent hernias.[7]