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Dr. R.K. Mishra at World Laparoscopy Hospital performs a Suprapubic Incisional Hernia Repair using Mishra's Knot and Mobilization of the Urinary Bladder in this video. Suprapubic hernias are ventral hernias located less than 4 cm above the pubic arch in the midline. When the upper margin of a hernia is above the arcuate line, repair becomes more difficult, and these hernias are defined as large suprapubic hernias. Laparoscopic repair is the preferred treatment option for large suprapubic hernias due to low recurrence rates reported in the literature, which has also been observed in Dr. Mishra's study.

Suprapubic incisional hernias are relatively uncommon, accounting for only 3-5% of all ventral hernias. These hernias are typically caused by previous abdominal surgeries, and the defect in the abdominal wall allows intra-abdominal contents to herniate through the fascia.

Laparoscopic repair of suprapubic hernias is a minimally invasive technique that involves making several small incisions in the abdomen and using a laparoscope to visualize the hernia defect. The surgeon then uses specialized instruments to reduce the herniated contents and repair the defect, often using a mesh to reinforce the repaired area.

Mishra's Knot is a surgical knot used in laparoscopic surgery, which is designed to minimize suture material and reduce the risk of suture line complications such as infection and wound dehiscence. Mobilization of the urinary bladder is also an important part of the procedure as it allows for better visualization of the hernia defect and easier repair.

The benefits of laparoscopic repair of suprapubic hernias include less pain, shorter hospital stays, and quicker recovery times compared to traditional open surgery. In addition, laparoscopic repair has been shown to have lower rates of postoperative complications and recurrence compared to open surgery.

In conclusion, laparoscopic repair is the preferred treatment option for large suprapubic hernias due to its lower recurrence rates and minimally invasive approach. The use of techniques such as Mishra's Knot and mobilization of the urinary bladder can further improve the safety and efficacy of the procedure.

The laparoscopic approach offers several advantages over open surgery for the repair of suprapubic incisional hernias. Laparoscopic surgery allows for a more thorough exploration of the abdominal cavity, which can help to identify and treat any additional hernias or adhesions that may be present. This can help to reduce the risk of recurrence and improve long-term outcomes.

In addition, laparoscopic surgery offers a smaller incision size, which can lead to less postoperative pain and faster recovery times. Patients may also experience less scarring and fewer wound complications with laparoscopic surgery, which can further improve their overall recovery experience.

However, there are some potential risks associated with laparoscopic hernia repair, including bleeding, infection, and damage to nearby organs or structures. It is important for patients to discuss these risks with their surgeon and to carefully follow all postoperative instructions to minimize the risk of complications.

Overall, laparoscopic repair of suprapubic incisional hernias is a safe and effective treatment option that offers several advantages over traditional open surgery. With careful patient selection and appropriate surgical technique, most patients can expect a successful outcome with low rates of recurrence and minimal complications.