laparoscopy

 

Laparoscopic Surgery

 

Laparoscopic Surgery

 

Laparoscopy Applications

 

 

Definition wall hernias - inguinal or umbilical hernias

Wall hernias appear as "bumps" in the groin or the navel, which increase in size when patient is standing and sometimes decreases to disappear at bedtime. Inguinal hernias are more common in men than in women. The development of laparoscopic surgery has reached the realm of inguinal and umbilical hernias. Best indications are in patients with recurrent hernias and bilateral hernias and those who are to be operated on laparoscopically for other reasons

Two concepts have revolutionized the surgical treatment of inguinal hernias in recent years. The use of preperitoneal prosthetic material for hernia repair, popularized by Stoppa and Rives and secondly the concept of Lichtenstein tension-free herniorrhaphy. These two arguments come together in the preperitoneal laparoscopic repair with mesh placement.

Questions and answers wall hernias.

Is it possible to operate the wall hernias laparoscopically?.

Technological evolution and development of new technology and the experience and skill of the surgeon, it has been the correction of inguinal hernias and umbilical regular size with laparoscopic surgery.

In the case of inguinal hernia on one side, there is some controversy in the application of laparoscopic techniques, but his lead has been clarified in recurrent hernias and in patients who have hernias on both sides of the inguinal region.

What are the advantages of laparoscopic surgery?

You do not need him groin incisions so there is less tissue invasion with much smaller wounds. Hernia repair is free of tension, with excellent visualization of the pelvic floor and abdominal wall can check the bilaterality of the lesion with low rate of intraoperative and postoperative complications, there is less tissue dissection and rupture of the anatomical planes The patient has less postoperative pain, recovery is a few days and return to normal activity is short-lived.

Are there any drawbacks of this type of operation?

It is desirable if not required to be performed by surgeons skilled in advanced laparoscopy, requires technological devices, thus being more expensive than conventional surgery. It requires general anesthesia.

Applying laparocópica surgery in the treatment of inguinal hernias, shall be subject to the discretion of the surgeon, looking primarily patient safety and the success of the operation. Giant inguinal scrotal hernias or irreducible are not easy to handle laparoscopically and would be best avoided.

How do you operate laparoscopic inguinal hernia?

There are two surgical techniques Transabdominal preperitoneal a (TAPP) and totally extraperitoneal (TEP) in the former place a mesh size sufficient to cover all potential areas of herniation using it to meet this objective, 10x 15 cm, this screen is set helical suture device level Protak pubic tubercle, Cooper's ligament, the transverse aponeurotic arch and rectus muscle. The second technique is to make a peritoneal cavity ahead until you reach the symphysis pubis by placing a polypropylene mesh of 12 x 15 cm, which covers the abdominal wall laterally reflected in the tract iliopubic and cover several centimeters of the psoas muscle , making its attachment to the ligament of Coope.

What kind of anesthesia will I need to do this?

Usually general anesthesia is required in selected patients in the extraperitoneal technique can be performed under regional anesthesia (epidural). However it is preferable for better relaxation and sedation of the patient, the use of general anesthesia.

Wall hernias laparoscopic surgery

There are two surgical techniques Transabdominal preperitoneal a (TAPP) and totally extraperitoneal (TEP) in the former place a mesh size sufficient to cover all potential areas of herniation using it to meet this objective, 10x 15 cm, this screen is set helical suture device level Protak pubic tubercle, Cooper's ligament, the transverse aponeurotic arch and rectus muscle. The second technique is to make a peritoneal cavity ahead until you reach the symphysis pubis by placing a polypropylene mesh of 12 x 15 cm, which covers the abdominal wall laterally reflected in the tract iliopubic and cover several centimeters of the psoas muscle, making its attachment to the ligament of Coope.

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Laparoscopy - Laparoscopic surgery