Having Laparoscopic Hernia Repair: TEPP

Once you know you have a hernia, you and your doctor can discuss laparoscopic surgery to repair it. Laparoscopic surgery is done with a laparoscope, a tiny “telescope” attached to a camera. It allows your surgeon a close-up view of your hernia using only small incisions. Because large incisions are not required, recovery from laparoscopic surgery is often faster and less painful than after open surgery. The surgery usually takes 1–2 hours. You can likely go home the same day.

Preparing for Surgery

• Schedule lab tests: You may have blood tests, an ECG (electrocardiogram), and a chest x-ray. These tests help ensure that your heart and lungs are healthy enough for surgery.

• Ask about medications: Before surgery, you may be told to stop taking some medications, such as aspirin, ibuprofen, or herbal remedies.

• Quit smoking: To avoid straining your hernia from “smoker’s cough” and to promote good blood flow for healing, ask your doctor for help quitting smoking.

• Avoid heavy lifting: Avoid putting strain on your hernia. Don’t do any heavy lifting before your surgery.

• Keep your stomach empty: Don’t eat or drink anything (not even water) after midnight the night before surgery. Your surgery may be canceled if you eat or drink before surgery. If you take any regular medications and have been told to continue them, take them with small sips of water.

• Arrange for help after surgery: Plan to have someone drive you home afterward. You’ll want to take it easy after surgery, too, so you may need extra help at home.

Just Before Surgery

• You’ll be asked to sign consent forms.

• Your doctor or anesthesiologist will talk with you about the anesthesia you’ll be given during surgery.

During the Procedure

• You’ll be given general or regional anesthesia. This keeps you free from pain during surgery.

• You will have 3–4 small incisions. The laparoscope and other instruments are inserted through these incisions. The laparoscope has a tiny video camera that sends clear images to a video monitor.

• Your surgeon will be using the extraperitoneal (TEPP) approach to the surgery. This means that the laparoscope and other instruments are used under your skin, but outside the peritoneum.

• Carbon dioxide gas is injected into your abdomen through an incision near your navel. The gas inflates your abdomen, allowing your surgeon to work.

Placing the Patch

The surgeon repairs the hernia, then places strong mesh directly over the weak spot in your abdominal wall. The mesh acts just as a patch would on a tire wall. The mesh is secured with surgical staples, tacks, clips, or sutures. These stay in place permanently. Neither the mesh nor staples are harmful to your body. Other reinforcement methods besides mesh may be used. After the mesh is applied, the gas is released from your abdomen.