Surgery for a hernia involves two approaches: the open technique, in which an incision is made near the site of the hernia, opening the skin and underlying connective tissue to expose the hernia and repair it from the front; or the laparoscopic technique, which involves making smaller incisions into the abdominal wall and using a camera and surgical tools, repairing the defect from behind. Each method has advantages and disadvantages. Some of the complications are more pronounced with laparoscopic repair, and some more so with the open technique.
Pain and Functional Impairment
Pain is a very common experience after hernia surgery. It may be acute and shorter lived, or become a chronic issue. According to a December 2003 article in the "British Journal of Surgery," laparoscopic surgery is associated with less pain than the open technique. As such, it is also associated with less recovery time and functional impairment, defined by most studies to be the time to return to work, which is a few days after the laparoscopic surgery for most people.
Recurrence
Recurrence is the return of the hernia after the surgery has been performed, and is one of the most common complications. Recurrence is more likely with a laparoscopic repair and least likely with an open mesh technique. A study in the April 2004 issue of the "New England Journal of Medicine" placed the risk of recurrence with the laparoscopic technique after two years at 10 percent versus 4 percent for the open mesh technique. The risk of recurrence, as well as other complications, is reduced if it is performed by a surgeon who is experienced in using the technique.
Major Complications
Major complications of laparoscopic hernia repair are generally those that damage organs or are life threatening. The study in the April 2004 issue of the "New England Journal of Medicine" found a rate of major complications for laparoscopic hernia repair of 1 percent versus 0.1 percent for the open technique. Examples of major complications include blood vessel and nerve injuries, damage to the bladder and obstruction of the intestines.
Standard Complications
Standard complications are those which are found in every surgical procedure. These include bleeding, infections and complications from anesthesia. According to MayoClinic.com, anesthetic risks have a very low rate of occurrence, but include awareness during surgery, temporary confusion, pneumonia, heart attacks, stroke and death.
References
- "European Journal of Surgery"; Surgical outcome and cost-minimisation-analyses of laparoscopic and open hernia repair: a randomised prospective trial with one year follow up; Kald, Anderberg, et al.: July 1997
- Mayo Clinic: Inguinal Hernia: Treatments and Drugs
- "New England Journal of Medicine"; Open mesh versus laparoscopic mesh repair of inguinal hernia; Neumayer, et al.; April 2004
- "British Journal of Surgery"; Meta analysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair; Memom, Cooper, et al.; December 2003
- Mayo Clinic: General Anesthesia: Risks
