Umbilical and Paraumbilical Hernia is now Gold Standard by Laparoscopy
It's now technically possible to repair every hernia by a laparoscopic approach. There remains some debate in surgical circles whether a laparoscopic repair is the appropriate kind of surgery for sure varieties of hernia. Generally, I love to repair hernias laparoscopically wherever possible. The best benefit of laparoscopic surgical procedures are enterprise post-operative pain along with a more rapid resume normal activities. All hernia repairs are performed while using insertion of a prosthetic mesh. The meshes used are among 2 types; either polypropylene or polyester. Polyester meshes happen to be found in India for a while but have only also been brought to North India. Polyester meshes have certain characteristics that will make them better for hernia repair. These are simple to handle through the surgeon’s perspective and they are generally not as likely to shrink. I therefore use polyester mesh for all of my hernia repairs. Inguinal or groin hernias could be repaired laparoscopically having a number of different techniques.
The most frequent technique nationwide may be the laparoscopic extraperitoneal repair (TEP repair) whereas in India they've got tended to favour the intra-abdominal repair (TAP repair). The TEP repair is technically more demanding but avoids the potential for loss of entering the abdominal cavity. As the TEP repair is technically more difficult, historically the recurrence rates have been higher than open hernia repair, though the roll-out of new mesh materials and changes in surgical technique, over time outcomes are now just like - otherwise better - than open inguinal hernia repair. However it needs to be emphasised that TEP inguinal hernia repair must be performed by an experienced laparoscopic surgeon with appropriate learning the tactic. TEP inguinal hernia repair isn't feasible in some patients, particularly men that experienced prostate surgery, along with these circumstances a TAP type repair offers an appropriate laparoscopic alternative. Laparoscopic hernia repair would be considered the defacto standard operation for recurrent groin hernias as well as patients with bilateral groin hernias.
Up to 25% of patients which has a unilateral groin hernia use a hernia on the reverse side when examined and investigated. A new and exciting division of laparoscopic hernia repair has become laparoscopic repair of umbilical and incisional hernias. Most of these repair allow the hernia defect to become examined from inside in addition to being is often the case with incisional hernias, other smaller hernias which are not clinically apparent, are located laparoscopically. This enables a mesh of appropriate size to become placed to hide both the main defect as well as the smaller defects which, if untreated, would eventually present as recurrent incisional hernias in a long time in the future. Laparoscopically repair of incisional hernias avoids the requirement for major abdominal incisions leading to faster patient recovery much less post-operative pain. Laparoscopic repair of these kinds of hernias does require using special non-adherent mesh that can be placed inside the abdominal cavity. Laparoscopic repair of incisional hernias has been shown to have a very lower recurrence rate and lower infection rate than the more traditional open operation.
3 COMMENTS
Dr. Anshu Raj
#1
Jun 16th, 2020 7:03 am
Thanks for posting of Umbilical and Paraumbilical Hernia video with good voice over, we are blessed to this nice surgery. Thanks.
Dr. Anu
#2
Jun 16th, 2020 11:33 am
Great dissection & demonstration of the Umbilical and Paraumbilical Hernia. I think every young surgeon and gynecologist must watch this video. This video helped to improve surgical skills.
Dr. Sam
#3
Jun 17th, 2020 2:05 pm
I would like to congratulate you on this excellent video and operation. Thanks for posting this educational video of Umbilical and Paraumbilical Hernia.
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