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Q&A with Australian Health Practitioners
Can my hernia be repaired with a “keyhole” operation?
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Mr Geoff Kohn
Upper GI Surgeon (Abdominal)
Assoc Prof Geoff Kohn is an Upper Gastrointestinal Surgeon in Melbourne, specialising in minimally-invasive management of diseases of the oesophagus and stomach. Geoff’s interests include: … View Profile
In very general terms, the answer is “yes”! All types of hernia can be repaired “laparoscopically”. During a laparoscopic (keyhole) operation, your surgeon makes a few small incisions. One allows the placement of a small camera inside, and the other incisions allow placement of narrow instruments inside to allow the performance of the operation.
Groin hernias (also called ‘inguinal’ or ‘femoral’ hernias) are very well repaired laparoscopically. Particularly useful for people with hernias on both sides of the body or with recurrent hernias, laparoscopic surgery offers less pain and earlier return to full activity than traditional “open” techniques. Keyhole techniques also allow a larger area to be reinforced with mesh that standard open techniques. There is less chance of chronic pain after keyhole groin hernia repair.
Hernias at the site of previous operation scars are termed ‘incisional hernias’. Laparoscopic repair is an excellent choice for these hernias. Frequently the hernias are bigger than expected, and by looking from the inside, the surgeon can identify this and repair the entire weakness. Infections and problems with the wound are less frequent with the laparoscopic technique.
Hiatus hernia (sometimes called ‘hiatal hernia’) is a specific type of hernia through the diaphragm muscle which is the muscle which separates the abdomen from the chest. The oesophagus (food pipe) passes through the diaphragm on its way from the mouth to the stomach. When the stomach slides up alongside the oesophagus and into the chest, this forms a hiatus hernia. This type of hernia can cause pain, vomiting, heartburn, bleeding and shortness of breath. Keyhole surgery is the gold-standard technique to repair these hernias.
Sometimes laparoscopic repair is not possible. Most of the time, this only becomes apparent during the course of the hernia repair operation, and your surgeon will explain that any laparoscopic operation might need to be completed by the traditional open technique. The reason is often the presence of scarring from previous operations, or occasionally the size of the hernia. Keyhole surgery needs a full general anaesthetic, where the patient goes fully off to sleep. Some people are not well enough for a full general anaesthetic and so cannot have a keyhole hernia repair. Please ask your doctor if laparoscopic hernia repair might be suitable for you, or please contact me for more information.
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