Simultaneous Laparoscopic Treatment of Multiple Synchronous Hernia Defects in Different Anatomical Regions of the Anterior Abdominal Wall

Abstract

The development of laparoscopic surgery influences greatly the contemporary surgical treatment. This influence is even more obvious in the treatment of abdominal wall hernias. While this pathology is widely spread, the different types of hernias could present as a single medical condition or as a combination of defects in different regions of the anterior abdominal wall.The laparoscopic approach in the treatment of abdominal wall hernia enables the inspection of the whole abdominal wall, which sometimes leads to detection of defects, which were not found during the clinical examination before the surgery. On the other hand, this diagnostic sensitivity provides an opportunity for simultaneous definitive treatment of several abdominal wall defects. Hence the need for repeated surgical interventions and multiple incisions is avoided. At the same time, the patient benefits from the well-known advantages of the minimally invasive surgery like - shorter hospital stay, less pain, faster return to everyday activity, better cosmetic results, less surgical site infections, etc. For example, the three-trocar technique of TAPP provides an access for the simultaneous reparation of bilateral inguinal hernias. Placing two additional ports makes the reconstruction of the existing primary or incisional ventral hernia feasible. Laparoscopic surgery makes the one-stage reconstruction of various combinations of anterior abdominal wall hernias possible - from a concomitant small unilateral inguinal hernia and an umbilical hernia to large bilateral inguinal hernias and multiple defects of the rest of the abdominal wall (Swiss cheese).