Laparoscopic Inguinal Hernia Repair (TEP) Treatment

What is an Inguinal Hernia?

An inguinal hernia is the very common type of hernia. It can appear as swelling or lump in the patient’s groin, or as an enlarged scrotum (the pouch containing the testicles). The swelling may be painful. The lump generally appears when the patients are lifting something and disappears when the patients lie down.

When does the patient require surgery?

Inguinal hernias can be repaired by the use of surgery to push the bulge back into place and strengthen the weakness in the abdominal wall. The surgery is generally recommended if the patients have a hernia that results in the pain, severe or persistent symptoms, or if any other serious complications develop at a later stage.

Complications that can develop as a result of an inguinal hernia include the following:

Obstruction: Where a section of the bowel becomes stuck in the inguinal canal, resulting in the vomiting, stomach pain, and nausea, as well as a painful lump in the groin area.

Strangulation: Where a section of bowel becomes trapped and the blood supply is being cut off; this needs an emergency surgery within hours for releasing the trapped tissue and restoring its blood supply so it doesn't die.

Surgery gets rid of the hernia by preventing any serious complications, but there's a possibility that hernia could return after the surgery.

Symptoms leading to Inguinal Hernia Repair Treatment

Laparoscopic inguinal hernia repair is involuntary or symptom related from an inguinal hernia in which a part of the intestine or abdominal tissue protrudes through a weakened area in the groin muscles. Common symptoms that may indicate the need for laparoscopic inguinal hernia repair include:

• Visible Bulge
• Pain or Discomfort
• Burning or Aching Sensation
• Swelling and Heaviness
• Weakness or Pressure in the Groin
• Pain Radiating to Lower Abdomen or Testicles
• Incarceration or Strangulation Symptoms

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How can Inguinal Hernia be repaired?

There are 2 ways an inguinal hernia can be repaired, as mentioned below:

Open surgery: Where an incision is being made for allowing the surgeon to push back the lump into the individual’s abdomen.

Laparoscopic (keyhole) surgery: Laparoscopic is a little less invasive but more difficult, the technique involves several smaller incisions made, which allows the surgeon to use various special instruments for repairing the hernia

Laparoscopic (keyhole) surgery

The general anesthetic is required for keyhole (laparoscopic) inguinal hernia repair, so the patients will be asleep during the operation. During keyhole surgery, the surgeon generally makes three small cuts in the patient’s abdomen instead of a single larger cut. Then a thin tube containing called laparoscope which has a light source and a camera is being inserted through one of these cuts which allow the surgeon to view inside of the patient’s abdomen. Special surgical instruments are being used by the surgeon, who helps in pulling the hernia back into the place; these instruments are being inserted through the other cuts.

There are two types of keyhole (Laparoscopic) surgery:

Transabdominal preperitoneal (TAPP):

Instruments are being inserted through the muscle wall of the patient’s abdomen and through the lining covering the patient’s organs (the peritoneum). A flap of the peritoneum is peeled back over the hernia and a piece of mesh is glued or stapled to the weakened site in the patient’s abdomen wall for strengthening it.

Totally extraperitoneal (TEP)

Totally extraperitoneal is the newest keyhole (laparoscopic) technique, which involves repairing of the hernia without penetrating the peritoneal cavity. Once the repair is complete, the cuts in the skin are sealed with the help of stitches or surgical glue.

Laparoscopic (keyhole) repair of inguinal hernias have the following advantages over conventional repair:

• Keyhole repair reduces postoperative pain.
• The requirement of narcotics is being reduced.
• The patients can return to their work earlier than expected.

Laparoscopic repair has some disadvantages as well, which includes:

• Increased cost as compared to the conventional repair
• Lengthier operation as compared to the conventional repair
• Steeper learning curve
• Higher complication rates and recurrence early in a surgeon’s experience

Procedure for the TEP repair

To undergo TEP repair, the patients must have the ability to tolerate general anesthesia. Although TEP repair has been done with regional anesthesia, it is generally done with general anesthesia, and transition from regional to general anesthesia might be needed. Patients whose comorbidities preclude general anesthesia must undergo anterior repair either under a local anesthetic or regional anesthetic. Previous operations in the preperitoneal space (eg, retropubic prostatectomy and TEP) can result in the difficulty in the TEP repair. TEP is generally facilitated by the use of the space-creating balloons, which usually function poorly when the dense adhesions are present in the space of Retzius. Holes in the peritoneum are usually in reoperative preperitoneal procedure. Some surgeons may consider previous open appendectomy a relative contraindication for TEP repair in patients with right inguinal hernias. On at some point, the appendectomy scar complicates the lateral dissection, but this doesn’t prevent a safe and effective TEP repair. Previous low midline cuts can also make TEP repair much more difficult, but not impossible. Accessing to the preperitoneal space might be difficult and have to be moved to a more lateral location rather than the standard location in the midline. Once the access is achieved, TEP repair generally proceeds as normal in patients with previous low laparotomies.

Are there any risks from the surgery?

An inguinal hernia repair is a routine procedure with very few risks. But in some of the cases, a small number of hernias can return back at some point after surgery has been performed.

Other possible complications of an inguinal hernia repair may include the following:

• Fluid or blood builds up in the space left by the hernia (this generally gets better without the use of any treatment)
• Painful bruising and swelling of the testicles or the base of the penis (particularly in the men)
• Numbness and pain in the groin area which is being resulted by the getting damaged or trapped during the surgery.
• Damage to the blood supply to the testicles ( in the men)
• Damage caused to the vas deferens (it is the tube that carries sperm to the testicles)

Complications are more likely to occur if the patients are aged over 50, smoke or have any other illness, such as breathing problems or heart disease.

For the past years, India has become a favored country for medical treatments, including hernia repair surgeries. India is popular globally for its board certified surgeons, latest technology and affordable medical care service.Hernia surgery in India involves treatment for different types of hernias like inguinal, umbilical and hiatal.

What causes hernia?

Hernia is known to be caused by the following conditions:

• Weakness in the abdominal wall: The muscle tissue may be weakened by prior surgical incisions, aging, genetics, congenital abnormalities, or other circumstances.
• Increased abdominal pressure: A hernia may occur as a result of an activity or circumstance that causes an increase in abdominal pressure. Ascites, obesity, pregnancy, heavy lifting, chronic coughing, straining during bowel movements or urination, and abdominal fluid accumulation are a few examples.
• Trauma or injury: A direct abdominal trauma or injury can weaken the muscles and raise the possibility of a hernia.
• Chronic diseases: People are more susceptible to hernias if they have chronic disorders such chronic obstructive pulmonary disease (COPD), constipation, or prostate issues.

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Facilities and Services Offered for International Patients for Inguinal Hernia Repair Treatment

There are many hospitals for inguinal hernia repair treatment in the world; many of them have international facilities and services for the patient to make them feel comfortable. Here’s what many top healthcare facilities offer:

• Dedicated International Patient Departments
• Comprehensive Pre-Arrival Services
• Accommodation and Transportation Assistance
• Interpreter Services
• Post-Surgery and Recovery Support
• Tourist and Cultural Amenities
• Safety and Emergency Care

Pre-Treatment Process of Inguinal Hernia

There are several things that must be done before the operation can be carried out on a patient with inguinal hernia. Here’s an overview of what to expect:

• Initial Consultation and Diagnosis
• Preoperative Health Assessment
• Patient Education and Counselling
• Lifestyle Adjustments before Surgery
• Preparing for Hospital Stay
• Day-before Preparations
• Final Preoperative Check

Diagnostic Tests for Laparoscopic Inguinal Hernia Treatment 

In diagnosing femoral hernia and prior to surgery for femoral hernia repair, tests and examination may be performed in order to finalise a diagnosis, determine the severity of the hernia and plan the course of surgery. Here are the primary diagnostic tests involved:

• Physical Examination
• Ultrasound
• Computed Tomography (CT) Scan
• Magnetic Resonance Imaging (MRI)
• X-Ray (Abdominal)
• Blood Tests
• Differential Diagnosis

TEP Treatment

To undergo TEP treatment, the patients must have the ability to tolerate general anaesthesia. Although TEP treatment has been done with regional anaesthesia, it is generally done with general anaesthesia, and transition from regional to general anaesthesia might be needed. Patients whose comorbidities preclude general anaesthesia must undergo anterior repair either under a local anaesthetic or regional anaesthetic. Previous operations in the preperitoneal space (eg, retropubic prostatectomy and TEP) can result in the difficulty in the TEP repair. TEP is generally facilitated by the use of the space-creating balloons, which usually function poorly when the dense adhesions are present in the space of Retzius. Holes in the peritoneum are usually in reoperative preperitoneal procedure. Some surgeons may consider previous open appendectomy a relative contraindication for TEP repair in patients with right inguinal hernias. On at some point, the appendectomy scar complicates the lateral dissection, but this doesn’t prevent a safe and effective TEP repair. Previous low midline cuts can also make TEP repair much more difficult, but not impossible. Accessing to the preperitoneal space might be difficult and have to be moved to a more lateral location rather than the standard location in the midline. Once the access is achieved, TEP repair generally proceeds as normal in patients with previous low laparotomies.

Post-Treatment Process of Inguinal Hernia

Post treatment management after inguinal hernia repair is initial important step that can help one recover from the operation without any complications or extended stay in hospital. Here’s a breakdown of what patients can expect after the procedure:

• Immediate Postoperative Care
• Hospital Stay and Discharge
• Activity and Mobility
• Diet and Hydration
• Follow-up Appointments
• Incision and Wound Care
• Pain Management and Medication
• Gradual Return to Normal Activity
• Recognizing Complications
• Long-Term Care and Lifestyle Changes

Success Rate of Laparoscopic Inguinal Hernia Treatment

The high success rate for laparoscopic inguinal hernia repair, accomplished in 90–99% of patients, leads to long term relief of symptoms in the majority of patients.

About hernia repair surgery

Hernia is an abnormal condition in which an internal organ or tissue bulges through a hole or a weak area of the abdominal wall. Hernia repair is a surgical intervention primarily intended for treatment of a hernia. Hernias are discomforting, painful, and can lead to various complications in case they are not treated. A surgery is usually advised in order to prevent hernia from becoming more severe. Depending on where the hernia is located, there are various forms of hernia repair surgery, which are mentioned below.

Inguinal hernia surgery

• One of the most popular hernia repair techniques in India is inguinal hernia surgery. 
• When tissue, such as a portion of the intestine, protrudes through a weak area in the abdominal muscles, it can cause an inguinal hernia. 
• The ensuing bulge may hurt, particularly if you cough, bend down, or pick up something heavy. 
• Inguinal hernias account for up to 75% of all hernias. 

There are two main types of inguinal hernia surgery:

• Open Hernia Repair: In this process, the doctor uses a large incision to access the hernia and fix it through Traditionally, the surgeon sutures the muscles together so as to bring back the bulging tissue to its normal position.
• Laparoscopic Hernia Repair: This procedure is also referred to as a minimally invasive surgical procedure. In this procedure, the surgeon makes small incisions that are adequate to pass a laparoscope and instruments for repairing and fixing the hernia.

Umbilical hernia surgery

• An umbilical hernia causes a little protrusion or swelling in the area around the navel. 
• It happens when a portion of the intestine protrudes through the umbilical opening in the abdominal muscle. 
• This type of hernia is mostly seen in the new born babies but it can also be seen in adults due to factors such as obesity, pregnancy or overexertion of the abdominal muscles.
• Umbilical hernia repair involves simply placing the protruding structure back in the correct position and using stitching or mesh to strengthen the defect. 
• The operation is usually brief, and many patients are back to work within a week or so.

Hiatal hernia surgery

• When your upper abdomen protrudes via a hole in your diaphragm, you have a hiatal hernia. 
• This is a prevalent condition in older age groups.
• These symptoms include heartburn, acid reflux and other problems that relate to difficulty in swallowing.
• Hiatal hernia surgery is typically performed in conjunction with any related diseases including GERD to provide patients with full treatment.
• A large number of medical facilities in India are technologically advanced, which is why a growing number of foreign patients choose Indian hospitals to have hiatal hernia surgery.

Treatment of hiatal hernia in India

• The management of hiatal hernias depends on the degree of the disease. In mild cases, changes in lifestyle and prescription of drugs that help to lessen acid reflux will be enough. 
• Surgery may be necessary where the hernia is large or where the symptoms are severe or disturbing.
• Laparoscopic surgery is the most common way to treat hiatal hernia since it has the least invasive characteristic and offers a shorter period of recovery. 
• Hiatal hernia treatment is comparatively cheaper in India than many developed countries of the world, thereby becoming an added advantage to many foreigners. 

Epigastric pain treatment in India

• Epigastric pain is a pain localized in the upper abdominal region and can occur due to illnesses like gastritis, acid reflux or hernias. 
• Epigastric pain treatment methods include altering the patient’s diet, taking medication or undergoing surgery based on the cause of the hernias.
• If the cause of epigastric pain is hernia, surgery may be required to fix the hernia in order to cure the discomfort. 
• If the pain is due to hernia, then the only viable solution may be to have this hernia fixed through surgery. 
• The management of epigastric pain in India includes both conservative and surgical management. 
• There is significant understanding of Indian doctors in relation to patient care services particularly those with epigastric pain and this has led to the country being adopted as the medical tourism hub.

Why do international patients choose India for hernia surgery?

The best doctors, surgeons, and nurses are employed in Indian hospitals that specialize in hernia surgery. They collaborate to give patients the best possible care and medical attention. In addition, compared to other nations, India offers less expensive hernia surgery. International standards of healthcare are offered to patients by Indian hospitals, which boast state-of-the-art infrastructure.

Factors affecting the cost of hernia repair in India

In India, the cost of hernia surgery might vary depending on a few things. Among them are:

• Hernia Type
• Hospital Location
• Surgeon’s Expertise
• Treatment Approach
• Diagnostic tests

Best hospitals for hernia repair in India

• Fortis Memorial Research Institute, Gurgaon
• Medanta The Medicity, Gurugram
• Artemis Hospital, Gurugram
• Max Hospital, Delhi
• Apollo Hospitals, Delhi
• ?BLK-Max Super Speciality Hospital, Delhi

Best surgeons for hernia operation in India

• Dr. Amit Javed
• Dr. Adarsh Choudhary
• Dr. ? Paritosh S Gupta??
• Dr. ?Pradeep Chowbey
• Dr. Deepak Govil
• Dr. Deep Goel

Why Choose GetWellGo for Laparoscopic Inguinal Hernia Repair Treatment?

These are the some of the benefits accruable from seeking inguinal hernia repair treatment from GetWellGo because this company can assist international patients in the following ways; here are key reasons why GetWellGo might be an excellent choice for inguinal hernia repair:

• Specialized Medical Expertise
• Comprehensive International Patient Services
• Pre-Arrival and Travel Support
• Transparent and Affordable Pricing
• Comprehensive Postoperative Care
• Enhanced Patient Comfort and Convenience
• Travel and Accommodation
• Medical Visa Assistance

Conclusion

Minimally invasive laparoscopic inguinal hernia repair has high success rates, low postoperative pain, rapid recovery, and low recurrence rates; is especially beneficial for bilateral or recurrent hernias. Outcomes are related to factors such as surgeon experience and patient health.

FAQ

1. How much time does recovery take following surgery for a hernia?

• The type of hernia surgery you have will determine how long it takes you to recuperate. In general, following surgery, you might need to miss a few weeks of work and refrain from physically demanding activities for a few months.

2. Is hernia repair surgery painful?

• You will be sedated during the procedure, so you won't experience any pain until the anesthesia wears off. After the procedure, you may experience some pain and discomfort, but this is normal and may be treated with medication. The pain gradually goes away as you heal.

3. Is hernia preventable?

• Simple lifestyle changes, such as losing weight, exercising frequently, eating a balanced diet, and drinking plenty of water to avoid constipation, can help prevent hernias.

4. How can I choose a hospital and physician for hernia repair in India?

• We will assist you in getting expert advice and the best treatment from a panel of specialists. You can contact us via phone at +91-9289678787 or email us at care@getwellgo.com

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