Our Approach
Personalized Treatment
Dr. Luís Couceiro specializes in the surgical treatment of all types of hernia of the abdominal wall. He usually favors laparoscopic techniques as a means of correcting abdominal hernias. In most cases it uses a net as a way to repair hernias according to the current state of the art in the treatment of hernias. We have the latest and most technically advanced networks and equipment at our disposal, thus hoping to significantly reduce pain and discomfort after surgery.
Hernia surgery can be described based on three specific categories:
- 1. Where the hernia is located: inguinal hernias (groin hernia), umbilical hernias (belly button hernia), as well as less common incisional, femoral and ventral hernias.
- 2. How the hernia is repaired: traditional open repair or laparoscopic.
- 3. They can be further classified as: unilateral (one side of the body), bilateral (both sides of the body), or recurrent (after a prior surgical repair).
Surgical Options in Inguinal Hernia
Laparoscopic surgery TAPP
The Trans-Abdominal Pre-peritoneal Repair (TAPP), is the most used technique in our center, using the laparoscopic approach to correct inguinal hernia. With this technique, a 5 mm camera is inserted into the abdominal cavity, after which two more 5 mm trocars are inserted. The gas is introduced into the abdominal cavity, allowing the surgeon to see the hernia and the hernia sac. The hernia is repaired using a mesh that is placed behind the abdominal wall muscle.
The principle advantages of this technique over open surgery are:
- Less post operative pain
- A quicker recovery
- A quicker return to full physical activities
- There is no significant difference in the recovery after TEP or TAPP repair
What complications can occur?
- Pain
- Bleeding
- Wound infection
- Mesh infection
- Scar
- Difficulty passing urine
- Atrophy of the testicle (Shrinkage)
- Hernia recurrence
- Deep Vein Thrombosis, Pulmonary Embolus
- Bowel injury
- Seroma
Open mesh repair - 'Lichtenstein type repair'
The hernia repair with tension-free mesh placement is the technique most commonly used to repair inguinal hernias. An incision is made in the groin, to expose the weakness in the abdominal wall.
If there is a sac associated with the hernia, it is called an indirect hernia. In this case, the bag is reduced or excised. When there is no hernial sac, the hernia is a direct hernia. In this case, the weakened layers of the posterior inguinal canal are repaired and reinforced with the placement of a mesh or mesh.
In either case, for both direct and indirect hernias, a synthetic mesh is placed between the layers of the oblique muscles. The mesh is secured in place with sutures. The purpose of the mesh is to cover the area of weakness and produce a strong repair.
What does the operation involve?
The surgery is usually performed under general anesthesia or spinal anesthesia with you awake. The groin area is temporarily paralyzed. The operation takes approximately 30 minutes. You can usually go home on the same day of the operation. Repair is uncomfortable for 5-10 days after surgery. During this time, you must rest and avoid making efforts. As the discomfort improves, you can gradually increase your daily exercise, in particular walking, to strengthen your abdominal muscles.
What complications can occur?
- Pain
- Bleeding
- Wound infection
- Mesh infection
- Scar
- Difficulty passing urine
- Numbness around the scar
- Atrophy of the testicle (Shrinkage)
- Hernia recurrence
Complications After Surgery
Although complication occur rarely with this type of surgery. All patients should understand the range of possible complications of the procedure before they agree to undergo a particular procedure.
- Hernia recurrence
- Nerve injury
- Wound infection
- Mesh Infection
- Pain
- Testicular injury
- Seroma
- Intestinal injury