Hernia repair is a

surgical operation Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery ...

for the correction of a

hernia A hernia (: hernias or herniae, from Latin, meaning 'rupture') is the abnormal exit of tissue or an organ (anatomy), organ, such as the bowel, through the wall of the cavity in which it normally resides. The term is also used for the normal Devel ...

—a bulging of

internal organs In a multicellular organism, an organ is a collection of tissues joined in a structural unit to serve a common function. In the hierarchy of life, an organ lies between tissue and an organ system. Tissues are formed from same type cells to a ...

or tissues through the

wall A wall is a structure and a surface that defines an area; carries a load; provides security, shelter, or soundproofing; or serves a decorative purpose. There are various types of walls, including border barriers between countries, brick wal ...

that contains it. It can be of two different types: herniorrhaphy; or hernioplasty. This operation may be performed to correct hernias of the

abdomen The abdomen (colloquially called the gut, belly, tummy, midriff, tucky, or stomach) is the front part of the torso between the thorax (chest) and pelvis in humans and in other vertebrates. The area occupied by the abdomen is called the abdominal ...

groin In human anatomy, the groin, also known as the inguinal region or iliac region, is the junctional area between the torso and the thigh. The groin is at the front of the body on either side of the pubic tubercle, where the lower part of the abdom ...

, diaphragm,

brain The brain is an organ (biology), organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It consists of nervous tissue and is typically located in the head (cephalization), usually near organs for ...

, or at the site of a previous operation. Hernia repair is often performed as an ambulatory procedure.

Techniques

Inguinal hernia repair

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. An operation in which the hernia sac is removed without any repair of the

inguinal canal The inguinal canal is a passage in the anterior abdominal wall on each side of the body (one on each side of the midline), which in males, convey the spermatic cords and in females, the round ligament of the uterus. The inguinal canals are lar ...

is described as a herniotomy. When herniotomy is combined with a reinforced repair of the posterior inguinal canal wall with autogenous (patient's own tissue) or

heterogeneous Homogeneity and heterogeneity are concepts relating to the uniformity of a substance, process or image. A homogeneous feature is uniform in composition or character (i.e., color, shape, size, weight, height, distribution, texture, language, i ...

material such as prolene mesh, it is termed hernioplasty as opposed to herniorrhaphy, in which no autogenous or heterogeneous material is used for reinforcement.

Stoppa procedure

The Stoppa procedure is a tension-free type of hernia repair. It is performed by wrapping the lower part of the

parietal peritoneum The peritoneum is the serous membrane forming the lining of the abdominal cavity or coelom in amniotes and some invertebrates, such as annelids. It covers most of the intra-abdominal (or coelomic) organs, and is composed of a layer of mesothe ...

with

prosthetic In medicine, a prosthesis (: prostheses; from ), or a prosthetic implant, is an artificial device that replaces a missing body part, which may be lost through physical trauma, disease, or a condition present at birth (Congenital, congenital disord ...

mesh and placing it at a preperitoneal level over Fruchaud's myopectineal

orifice An orifice is any opening, mouth, hole or vent, as in a pipe, a plate, or a body * Body orifice, any opening in the body of a human or animal *Orifice plate, a restriction used to measure flow or to control pressure or flow, sometimes given specia ...

. It was first described in 1975 by Rene Stoppa. This operation is also known as "giant prosthetic reinforcement of the

viscera In a multicellular organism, an organ is a collection of tissues joined in a structural unit to serve a common function. In the hierarchy of life, an organ lies between tissue and an organ system. Tissues are formed from same type cells to a ...

l sac" (GPRVS). This technique has met particular success in the repair of bilateral hernias, large scrotal hernias, and recurrent or rerecurrent hernias in which conventional repair is difficult and which carries a high

morbidity A disease is a particular abnormal condition that adversely affects the structure or function of all or part of an organism and is not immediately due to any external injury. Diseases are often known to be medical conditions that are asso ...

and failure rate. The most recent reported recurrence rate (involving 230 patients with 420 hernias and a maximum of 8 years follow-up) was 0.71%. The totally extra-peritoneal repair (TEP) uses exactly the same principles as the Stoppa repair, except that it is performed

laparoscopically Laparoscopy () is an operation performed in the abdomen or pelvis using small incisions (usually 0.5–1.5 cm) with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few small cuts in the abdomen.Medlin ...

Advancements in Hernia Repair

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.

References

External links

European Hernia Society guidelines on the treatment of inguinal hernia in adult patients.

American Hernia Society

{{Digestive system surgical procedures Hernias Surgical procedures and techniques Digestive system surgery