Classic abdominal hernia surgery

To begin with, it must be said that our clinic primarily focuses on laparoscopic surgical techniques. However, if laparoscopic surgery is not necessary, for example, in the case of small umbilical or epigastric hernias without abdominal muscle separation, we resort to classic repair techniques for these hernias.

What does “classic abdominal hernia surgery” mean?

In classic surgery, we make a skin incision at the site of the hernia, penetrate to the hernia sac, reduce the contents of the hernia back into the abdominal cavity, and then manually suture the abdominal wall using individual specially placed stitches. We finish the operation by suturing the subcutaneous tissue and skin.

When do we resort to the classic technique for operating on abdominal hernias at our clinic?

First, this is done for patients who have a small umbilical or epigastric hernia without the presence of abdominal muscle separation (diastasis). We perform the surgery under general anesthesia, and with a small incision below the navel, we access the hernia sac, which we return to the abdominal cavity after dissection. We then suture the hernia opening by overlapping its edges in a roof-like fashion, creating a doubling of the layers of the abdominal wall at this point (Mayo repair). The skin of the navel is then reattached to the abdominal wall, resulting in a recessed umbilical scar.

Furthermore, we use this classic technique to operate on older high-risk patients with an inguinal hernia who would not tolerate general anesthesia well. We perform the surgery under local anesthesia combined with sedation under the supervision of an anesthesiologist. We make a classic oblique incision in the groin above the hernia, and after dissecting the layers, we access the hernia sac, which we separate from the surrounding structures and return to the abdomen. We close the defect in the groin either using a mesh (PHS) or with individual stitches if the surrounding tissues are sufficiently strong and of good quality. 

In conclusion:

Other abdominal hernias not mentioned above, including even large ventral hernias in scars, are addressed exclusively with laparoscopic techniques, as this method has several advantages over classic surgery, such as better cosmetic results, less tissue trauma, reduced postoperative pain, lower risk of recurrence, and a lower percentage of inflammatory complications, etc.