Inguinal hernia in laparoscopy, why?

Laparoscopic surgery of inguinal hernia 

When, after diagnosis, I propose to a patient to operate on his inguinal hernia laparoscopically, it is natural for me to be bombarded with questions.

In fact, inguinal hernias can be operated on under local anesthesia using relatively simple, widely standardized, and highly effective techniques.

Laparoscopic inguinal hernia, inguinal hernia surgery, inguinal hernia, inguinal hernia pain, inguinal hernia surgery,

However, there are many considerations in favor of laparoscopic inguinal hernia repair., that chart the way in choosing the technique.

The first comes from a long way back; from 1647 even, the year when French physicist and mathematician Blaise Pascal discovered his famous law.

In his experiment, Pascal introduced a 10-meter-long pipe into a barrel filled with water, then filled the pipe with water as well: the result was that the pressure inside the barrel increased so much that it broke.

Applied to hernia surgery, Pascal's law tells us that when the mesh we use to repair a hernia is placed on the inner surface of the herniated defect area, it is the same pressure present inside the abdomen that anchors it to the abdominal wall; whereas if we place it on the outer surface, the pressure tends to make it detach.

So operating aninguinal hernia laparoscopically means to perform a surgery in which the repair is more stable than that done "from the outside." And this is a very, very good reason to propose the surgery of repairing the inguinal hernia in laparoscopy..

Another important reason is that by operating on aninguinal hernialaparoscopically, we are able to diagnose the possible presence of other wall defects, which are often present in these patients and not looked for or not seen by the examiner-such as, for example, an umbilical hernia or a contralateral inguinal hernia, i.e., on the other side, a crural hernia-and repair them during the same surgery.

TAPP hernioplasty - plug

Third, equally central reason: laparoscopic inguinal hernia surgery causes much less postoperative pain than surgery performed conventionally.

What's more, many (most) surgeons who operate openly have the habit of using "plugs ," which are sort of "plugs" of plastic material that are inserted into the inner inguinal ring for the purpose of reducing its size. This is a very bad habit, because these plugs have an unpleasant tendency to migrate, often ending up inside the abdominal cavity and causing adhesions with the intestinal loops, which, in the most serious cases, can end up injured by these plastic boulders, up to intestinal perforation.

In the photograph above, here is what we found in one of our last surgeries: a plug that had entered the abdominal cavity, causing severe adhesions with peritoneal fat and intestinal loops. And it was not the firsttime.

Remember: if you are going to have surgery for aninguinal hernia, ask the Surgeon if he plans to use a plug; if he says yes, think about it!

So, summing up:


Better repair of the herniated defect, with larger mesh and optimal tightness
Ability to diagnose and repair other hernias that escaped diagnosis during surgery
Less postoperative pain

These are the reasons - and they are not a few! - to propose laparoscopic inguinal hernia repair surgery. Add to this the fact that, for years now, the scientific community of surgeons dealing with the abdominal wall has established that laparoscopic inguinal hernia surgery represents the "gold standard" for the treatment of this frequent, bothersome and sometimes very serious condition.

However, probably following ingrained habits that make open inguinal hernioplasty surgery a surgery that can be performed by any surgeon, even those who are not particularly specialized in abdominal wall surgery, and also because laparoscopic inguinal hernia surgery is by no means simple, but involves a long and arduous learning curve, today the vast majority of surgeons do not engage in laparoscopic inguinal hernia surgery. Obviously, to the great detriment of the patient.

Laparoscopic inguinal hernia surgery in my center

laparoscopic inguinal hernia

For years I have been working to make my center, the St. Catherine of Siena Clinic in Turin, Italy., a Center of Excellence for the treatment of abdominal wall pathologies, particularly insisting on minimally invasive laparoscopic surgery. I introduced, first in Europe, the endoscopic diastasis surgery of the rectus abdominis muscles (of which I now hold the largest case history in the world) and, first in the world, the surgery of large laparoceles by endoscopy, with an original technique derived from the Carbonell-Bonafé technique, also with preoperative preparation with botulinum toxin and progressive pneumoperitoneum for the reconstruction of the space in the abdominal cavity (techniques well known and widely used abroad, but practically unknown in Italy; in this, too, excuse my lack of modesty, I arrived first...). Continuing on the path of offering the patient the best possible therapeutic choices, and in line with international recommendations, I have decided to offer inguinal hernia repair by laparoscopy to all my patients.. Operationally, for the patient this involves general anesthesia instead of local, and one night of hospitalization.

How does the surgery take place? You can take a look at the video below to understand the basic surgical steps forlaparoscopic inguinal hernia repair.

How to get enrolled for this surgery? Simply schedule an appointment or a video consultation.


Otherwise, you can contact me with the form below:

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What our patients think of us is much more important than what we say.

Dr. Salvatore Cuccomarino
Cuccomarino, MD
Medical Surgeon Specialist in General Surgery
19 Villa della Regina Street
Phone 0118199300