The repair can be done 2 ways.
Keyhole (laparoscopic) surgery. Your surgeon makes several small punctures or incisions in your abdomen and then inserts hollow tubes into the openings. They’ll then inflate your abdomen with a gas to see your internal organs and put surgical tools and a light and camera through the tubes. Your surgeon repairs the hernia by placing a piece of mesh over the weak spot in your abdominal wall and then sutures or staples the mesh in place. They may decide to do the repair inside the peritoneum (the sac that contains all of your abdominal organs) or outside this sac.
Sometimes, your surgeon may need to change to an open procedure because of difficulties during your surgery.
Open surgery. Your surgeon makes an incision near the hernia site and pushes the bulging tissue back into your abdomen. They’ll remove the sac around the hernia and put mesh over the site. Your surgeon then attaches the mesh with sutures sewn into the stronger tissue. The site is closed using sutures, staples, or surgical glue.
Keyhole or open, which is best?
The choice of technique largely depends on:
- your general health – if you’re elderly or have other health problems, you may not be able to safely have general anaesthetic. In this case, open surgery using local anaesthetic may be advised instead of keyhole surgery.
- your surgeon’s experience – open surgery is more common than keyhole surgery, and not all surgeons have enough experience in keyhole techniques.
An open repair can usually be done with local anaesthetic, while a keyhole repair requires general anaesthetic, which has increased risks.
With keyhole surgery, there's usually less pain after your surgery because the cuts are smaller. However, the risks of serious complications, such as your surgeon accidentally damaging your bowel, are also higher with keyhole surgery. The risk of your hernia returning is similar for both operations.