49652 Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); reducible

Name of the Procedure:

Laparoscopy, surgical, repair, ventral, umbilical, spigelian, or epigastric hernia (includes mesh insertion, when performed); reducible
Common Name: Laparoscopic Hernia Repair

Summary

Laparoscopic hernia repair is a minimally invasive surgical procedure used to fix hernias in the abdominal wall. The procedure involves making small incisions to insert a laparoscope and surgical tools to repair the hernia and possibly place a mesh to reinforce the area.

Purpose

Laparoscopic hernia repair addresses hernias, which are bulges of internal organs or tissues through weak spots in the abdominal wall. The main goal is to return the displaced tissues to their proper location and strengthen the weakened area to prevent recurrence.

Indications

• Noticeable bulge in the abdominal wall
• Pain or discomfort in the hernia area, especially when lifting, bending, or coughing
• Symptoms such as nausea, vomiting, or bowel obstruction
• Diagnosis of a reducible hernia (one that can be pushed back into place)

Preparation

• Fasting for at least 8 hours before the procedure
• Adjusting or stopping certain medications, as advised by the doctor
• Pre-operative tests such as blood work, imaging studies, or EKG

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is asleep and pain-free.
2. Incisions: Small incisions are made in the abdomen.
3. Laparoscope Insertion: A laparoscope (a thin tube with a camera) is inserted through one of the incisions.
4. Mesh Placement: Surgical tools are used to repair the hernia and, if necessary, a synthetic mesh is placed to reinforce the area.
5. Closure: The instruments are removed, and the incisions are closed with sutures or surgical glue.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

Laparoscopic hernia repair is usually performed in a hospital or an outpatient surgical center.

Personnel

• Surgeon specialized in laparoscopic procedures
• Anesthesiologist
• Surgical nurses and technicians

Risks and Complications

• Infection at the incision sites
• Bleeding or hematoma
• Recurrence of the hernia
• Chronic pain or discomfort
• Injury to surrounding tissues or organs
• Blood clots

Benefits

• Reduced postoperative pain compared to open surgery
• Shorter recovery time
• Smaller scars and better cosmetic results
• Lower risk of recurrence with mesh reinforcement

Recovery

• Short hospital stay or same-day discharge
• Pain management with prescribed medications
• Avoiding heavy lifting or strenuous activities for a few weeks
• Follow-up appointments to monitor recovery

Alternatives

• Open hernia repair: Involves a larger incision and longer recovery time but may be necessary for large or complicated hernias.
• Watchful waiting: For asymptomatic or minimally symptomatic hernias, monitoring the condition without immediate surgery might be suitable for some patients.

Patient Experience

• During the procedure: Under general anesthesia, the patient will feel no pain and will be unconscious.
• After the procedure: Some discomfort and pain at the incision sites, managed with medications. Patients might feel bloated or have mild shoulder pain due to the carbon dioxide used to inflate the abdomen during surgery. These symptoms typically resolve within a few days.