Laparoscopic Hernia Surgery Vs Open Hernia Surgery | Which Hernia Repair Surgery is the Best?

Dr. Parthasarathy - one of the best hernia surgeons in Hyderabad discusses about the types of hernia repair surgery and the advantages and disadvantages of laparoscopic hernia surgery & open hernia surgery.

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Summary:

This is one of the most common questions that we encounter. .There is a group of patients who come to us seeking a laparoscopic repair for hernia. Similarly, there is a group of patients who are very fixed in their thoughts and saying that. “We do not want laparoscopic operation, but want only an open operation”. The patients always ask us, “Doctor, which is the best technique to do a hernia operation? Is it by laparoscopy or by open surgery?” We have so many of them in favor of or against both the kinds of surgery. Some people say, “Though in laparoscopy, the pain is less, it fails. Open surgery is best and so, go for the open one”. Similarly, there are a lot of people who say, “Open surgery is a very morbid operation. Do not go for it. Try and get it done laparoscopically. If this doctor says, “Laparoscopy is not good, go to some other surgeon who says that laparoscopy is good and get it operated by him. Hence, what decision do we take on this? How do we decide which kind of operation is better?”
First of all, one has to understand that, as of today, both open operation and laparoscopic operation exist for treating of hernia. This means that the same surgeon will do laparoscopic operation for hernia on certain patients and he will do an open operation for some patients. What does this mean? It means that it is not the procedure that is deciding, but actually, it is the type of hernia that decides which procedure will suit that hernia. Thus, you cannot have one single procedure to try to fit all your patients into that. It is like having a one sized shoe and fitting all feet into that. It can never happen. It will not work. Hence, the decision as to whether a laparoscopic or an open operation is required, is taken based on many other factors.
The first factor is dependant on the type of hernia - whether it is a small hernia or a large hernia. Where is the hernia located? Is it a belly button hernia or a groin hernia? Has any previous hernia operation failed...if somebody has undergone a hernia operation 10 years back, but the hernia has come back, then what is the overall physical condition of the patient? Is it a very elderly patient with a poor muscle tone or is it a young fit athlete or a weight lifter or a body builder or a sports man? The surgeon will consider all these factors before he decides which technique is suitable for the patient. For example, you can take the case of a patient who has a small belly button hernia and is an active sportsperson. He wants to resume his practices and wants to attend office quickly. The choice of operation for this patient will be a laparoscopic repair because we avoid a cut, we avoid a chance of prolonged recovery, the pain is lesser and he can quickly go back and join his office. On the other hand, there is a 60 years old lady, who is obese, who has undergone hernia operation twice in the past or 10 years back and she got back the hernia. She has come to us for hernia repair. In this patient, looking at all these factors, the choice of surgery will be an open operation. This is because of the fact that the patient is old, obese, has previous failed repairs and thus, the best suited procedure for her would be an open hernia operation with a modified technique. Hence, the question whether laparoscopy is better or an open surgery does not have value. What the question should be is, “For me, which one is the better operation?” The operation choice is individualized for each patient, based on many patient related factors and surgeon factors.



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