Introduction
Laparoscopic hernia repair is the modern, minimal access way to fix a hernia. Instead of one long cut over the bulge, the surgeon works through three small openings using a camera and thin instruments - and places a mesh behind the muscle to reinforce the abdominal wall.
For most patients with an inguinal, femoral or umbilical hernia, this means less post-operative pain, a 24-hour hospital stay, and return to office work within a week. Both sides can be repaired at the same operation when needed.
This guide explains exactly how laparoscopic hernia repair works, who it suits best, and how to think about it alongside the older open technique.
What is laparoscopic hernia repair?
Laparoscopic hernia repair is a technique where the hernia is fixed from inside the abdomen using a camera and three small (5 to 12 mm) ports. The two main approaches are TAPP (transabdominal preperitoneal) and TEP (totally extraperitoneal). In both, a mesh is placed behind the muscle to cover the defect from the inside.
The advantage of approaching the hernia from behind is mechanical: abdominal pressure now pushes the mesh against the wall instead of pushing the contents through the defect. Recurrence rates are very low - under 2% in experienced hands.
The operation is done under general anaesthesia and takes 45 to 90 minutes. Most patients are home within 24 hours and back to office work in a week.
Symptoms & when to seek help
- A diagnosed inguinal, femoral or umbilical hernia
- Bilateral hernias (both sides) that can be fixed in one operation
- A recurrent hernia after a previous open repair
- A hernia in someone who needs a quick return to work
- A hernia in someone who wants minimal scarring
Causes & risk factors
- A natural weakness in the abdominal wall
- Heavy lifting, particularly with poor technique
- Chronic cough or constipation
- Previous abdominal surgery
- Smoking and ageing
- Obesity
How it is diagnosed
- Outpatient consultation and physical examination
- Ultrasound or CT for small or unusual hernias
- Pre-operative blood tests, ECG and anaesthetic check
- A clear written estimate before admission
Treatment options
- General anaesthesia
- Three small incisions, 5 to 12 mm
- Mesh placed behind the muscle (TAPP or TEP)
- Bilateral hernias repaired in the same operation when present
- Closure with absorbable stitches, no large dressing
Recovery & aftercare
- Day 0: walking the same evening
- Day 1: discharge home
- Day 3 to 5: light activity and driving
- Week 1: return to office work
- Week 4 to 6: gym and heavy lifting
Risks of delaying care
- Hernia enlargement over time
- Strangulation - a true emergency
- Bowel obstruction
- Chronic discomfort affecting work and exercise
Frequently asked questions
Reviewed by
Dr. Sanjay Yadagiri
Consultant - Minimal Access Surgery & Surgical Oncology
Over three decades of surgical experience. UK-trained, France-certified in laparoscopic and colorectal surgery, with a long association with the Indo-American Cancer Institute and Omega Hospitals, Hyderabad.
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