Laparoscopic Hernia Repair

The laparoscopic hernia repair, a minimally invasive approach by using cameras to visualize the anatomy, was attempted by many in the mid 1990s with mixed success. The goal of the repair was to place a thin mesh between the abdominal wall and peritoneum, and thus decrease the risk of chronic pain caused by mesh placement within the abdominal wall, as with the plug and patch repair.

While the goal seemed simple, the execution was complicated because of lack of anatomical understanding and inexperience with laparoscopy.
In the early days, most low volume surgeons experienced a very high hernia recurrence rate as well as devastating vascular or intestinal injuries. This experience, however, was very important in improving our understanding of hernia anatomy.

Over the last decade surgeons have become better with this technique and centers that perform a high volume of this repair have excellent results and quicker return to activity for patients than  the traditional mesh repairs.    In the last few years, some surgeons started using the advanced laparoscopic platform created by Intuitive and marketer as a "Robot".  These $2 million machines allow surgeons to perform a laparoscopic hernia repair with a little more ease than can be done with regular laparoscopic instruments.    Although the term "Robotic" is used extensively, the repair is no different than laparoscopic hernia repair.  The outcomes are no different.  Laparoscopic surgery and Robotic hernia surgery must be done under general anesthesia.

The Fast Recovery Inguinal Hernia Surgery has the same identical outcome as laparoscopic or robotic inguinal hernia surgery, and is usually performed under local anesthesia with sedation in an ambulatory setting.   The advantages of this repair are clear in terms of quality and comfort, while also costing patients and employers a lot less than Robotic or Laparoscopic operations.  We contently look for ways to improve quality and reduce cost to the healthcare system.  Dr. Reinhorn switched from laparoscopic to the Fast Recovery Inguinal Hernia Surgery in 2004 because patients suffered less pain after surgery and did not need general anesthesia.  At this point all the data show that Robotic inguinal hernia surgery is a wonderful marketing tool, that ultimately increases cost without offering benefit to patients, except in very rare cases.