Hernias in the groin area (inguinal hernias) are extremely common. About 600,000 operations are performed yearly in this country to repair them. An inguinal hernia occurs when a sac of peritoneum, the lining of the abdominal cavity protrudes through a hole in the muscular wall of the lower abdomen. Part of the intestine can become entrapped, leading to strangulation and requiring an emergency operation. The cause of most hernias is not definitely known, although heavy physical activity, straining and coughing tend to enlarge a hernia once it is present. The only effective treatment is surgery, which is the best course in virtually all cases.

Until recently the operation to repair an inguinal hernia was generally done through a three to four inch incision made over the hernia with the sac being removed or pushed back into the abdominal cavity and a plastic mesh patch sutured over the weak area. In the last five years a method called laparoscopy has been available as an alternative to the standard technique. This new method has less post operative pain and an earlier return to heavy physical activity than the older method, and the success rate appears to be similar. It is usually a good approach when hernias are present on both sides or the hernia is a recurrent one.

With this method three or four small incisions, each less than 1/2 inch in length are placed in the mid abdomen and used to place hollow tubes(trochars) into the space behind the abdominal muscles. Carbon dioxide gas is pumped in to expand the space and a video camera device is passed through one of these trochars to allow the surgeon to see the anatomy on a video monitor. Dissecting instruments are passed through the other trochars to perform the operation. The hernia is pulled back from the muscle and a patch of plastic mesh secured over the muscular defect with tiny metal staples. The operation takes 25-30 minutes, approximately as long as the older technique and is done under general anesthesia. The patient can usually return home two or three hours later. Full physical activity can generally be resumed after one or two weeks, compared with over a month with the older conventional operation.