Endoscopic Hernia Surgery

At Biruni Hospital, our motto is where precision meets innovation. We take medical care very seriously and are committed to providing our patients with everything they need for optimal healing, including advanced technology and a highly experienced medical team.

One of the key procedures performed at our hospital is endoscopic hernia surgery. A hernia may begin as a small bulge, but it can quickly become a serious disruption to daily life. Fortunately, modern repair techniques allow for faster recovery, minimal scarring, and shorter hospital stays.

What is endoscopic hernia surgery

Endoscopic hernia surgery is a minimally invasive procedure used to repair hernias by reinforcing weak spots in the abdominal wall. Instead of a large incision, the surgeon makes a few small cuts to insert a camera (endoscope) and specialized tools, allowing a precise internal repair with minimal disruption to surrounding tissue.

This technique is especially effective for:

• Inguinal hernias
  
• Femoral hernias
  
• Umbilical hernias
  

Main types of endoscopic hernia surgery and their key steps

The main types of endoscopic hernia surgery are Totally Extraperitoneal Repair (TEP) and Transabdominal Preperitoneal Repair (TAPP). Both are minimally invasive procedures used to repair inguinal or other abdominal hernias.

TEP (Totally Extraperitoneal Repair)

TEP is one of the most advanced and commonly used endoscopic techniques for inguinal hernias. It is performed without entering the abdominal cavity, reducing the risk of internal organ injury and postoperative complications.

Procedure steps and aspects

• Anesthesia: General anesthesia is used for full muscle relaxation.
  
• Incision: A small cut is made below the navel, followed by insertion of a balloon dissector to create a working space.
  
• Trocar placement: Additional small incisions are made to insert surgical tools called trocars.
  
• Dissection: The hernia sac is carefully dissected while avoiding surrounding tissues.
  
• Mesh placement: A large synthetic mesh is inserted to cover the hernia and reinforce weak areas.
  
• Fixation: The mesh is fixed with surgical tacks or left in place through natural tissue pressure.
  
• Closure: Instruments are withdrawn, and the incisions are closed with sutures or skin glue.
  
  

TAPP (Transabdominal Preperitoneal Repair)

Unlike TEP, TAPP involves entering the abdominal cavity. An incision is made in the peritoneum (the abdominal lining) to provide easier access to the hernia site. This method offers a broader working space and improved visibility, making it ideal for complex or recurrent hernias.

Procedure steps and aspects

• Anesthesia: General anesthesia is administered
• Access: A small incision is made in the abdominal wall to introduce the laparoscope.
• Cavity inflation: Carbon dioxide is used to inflate the abdominal cavity.
  
• Peritoneal incision: The peritoneum is cut to reach the hernia.
  
• Hernia reduction: The hernia sac is isolated and pushed back into the abdominal cavity.
  
• Mesh placement: A large mesh is used to cover and reinforce the area.
  
• Incision closure: Tools are removed, gas is released, and the skin is closed.
  

ETEP (Enhanced View Totally Extraperitoneal Repair)

ETEP is an evolution of the TEP technique. It improves visibility and working space during hernia repairs and allows greater flexibility in port placement. It is suitable for both unilateral and bilateral hernias.

Procedure steps and aspects

• Anesthesia: General anesthesia ensures patient comfort.
  
• Port placement: Multiple ports are strategically placed for optimal visibility.
  
• Space creation: A working space is created using a balloon or direct dissection.
  
• Hernia dissection: The hernia sac is dissected while preserving anatomical structures.
  
• Fixation: The mesh is secured using self-gripping technology, tacks, or left unfixed.
  
• Exit: The procedure concludes with careful closure of the incisions.
  

SILS (Single-Incision Laparoscopic Surgery for Hernia Repair)

SILS is a modern refinement in hernia repair using a single entry point, typically through the navel. Though technically complex, it offers the benefit of no visible scarring.

Procedure steps and aspects

• Anesthesia: General anesthesia is used.
  
• Single entry point: A single incision is made at the belly button.
  
• Camera and tools: All necessary tools and the camera are introduced through this entry.
  
• Hernia identification: The hernia is located and evaluated from inside the cavity.
  
• Peritoneum management: If possible, the peritoneum is sutured over the mesh.
  
• Closure: The incision is closed with absorbable sutures for aesthetic healing.

The post-operative healing after an endoscopic hernia surgery

Post-operative healing after endoscopic hernia surgery is typically quick and involves minimal discomfort. Most patients experience mild pain or swelling at the incision sites, which improves within a few days.

The short-term recovery

Immediate healing period
After surgery, patients typically awaken within an hour. It is normal to experience light-headedness and mild to moderate abdominal discomfort. During this period, doctors will monitor you closely.

• Hospital stay duration: Most patients are discharged the same day, but some may stay longer depending on the complexity of the surgery.
  
• Pain management: Prescribed medications will help manage pain. Contact your doctor if discomfort persists.
  
• Early mobilization: Walking is encouraged within hours of surgery.
  
• Resuming routine activities: Most patients can return to normal daily routines within 5 to 7 days.
  

The long-term recovery

• Reintroducing physical activity
  Light activities such as walking or stretching can begin after a short time. Avoid strenuous activities (running, lifting, core exercises) for at least 6 weeks.
• Mesh integration and tissue strengthening
  Over time, the mesh integrates with surrounding tissue, creating a durable barrier to prevent recurrence.
• Lingering sensations
  Some patients may feel tightness, tingling, or numbness near incision sites. These symptoms are usually temporary.
• Monitoring and follow-up
  Post-operative visits are crucial to ensure proper healing and allow your doctor to monitor progress using imaging or physical examination.

A stronger tomorrow starts here

Endoscopic hernia surgery combines precision, efficiency, and fast recovery, minimizing disruptions to daily life. At Biruni Hospital, every step from consultation to post-op care is delivered with surgical excellence. If you're ready to reclaim your comfort and mobility, your journey begins here.