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Laparoscopic Incisional Hernia Repair after previous Mc Burney's incision
Gen Laparoscopic Surgery / Jul 24th, 2018 4:02 am     A+ | a-


This video demonstrate laparoscopic repair of Incisional hernia developed after Mc Burney's incision given during the previous open appendicectomy surgery 10 year back else where. Vipro mesh is used and surgery was performed by Dr. R.K. Mishra at World Laparoscopy Hospital.
 

Laparoscopic Incisional Hernia Repair after Previous McBurney’s Incision at World Laparoscopy Hospital

Incisional hernia is a well-recognized complication following abdominal surgery, particularly after open procedures such as appendectomy performed through a McBurney’s incision. Although the McBurney’s approach is traditionally considered safe and effective for open appendectomy, weakness in the abdominal wall at the incision site can later lead to herniation. At World Laparoscopy Hospital, advanced laparoscopic techniques are utilized to manage such complex incisional hernias with precision, safety, and excellent cosmetic outcomes.

A McBurney’s incision, typically placed in the right lower quadrant of the abdomen, involves splitting muscle layers to access the appendix. In some patients, especially those with wound infection, obesity, poor healing, or increased intra-abdominal pressure, the fascial closure may weaken over time, resulting in an incisional hernia. Clinically, patients present with a swelling at the previous surgical site, discomfort, dragging pain, or sometimes bowel obstruction in complicated cases.

Traditionally, open mesh repair was the standard treatment for incisional hernias. However, open repair is associated with larger scars, higher wound-related complications, and longer recovery periods. With advancements in minimal access surgery, laparoscopic incisional hernia repair has become the preferred approach in specialized centers. At World Laparoscopy Hospital, surgeons apply evidence-based laparoscopic techniques to ensure optimal patient outcomes.

The laparoscopic approach begins with careful port placement away from the previous scar to avoid adhesions. Pneumoperitoneum is established under vision, and meticulous adhesiolysis is performed to free the hernia sac contents, which often include omentum or bowel loops adherent to the old incision site. The hernia defect is clearly identified, and its size is measured accurately. A composite mesh is then introduced into the abdominal cavity and positioned to cover the defect with adequate overlap, usually at least 3–5 cm beyond the margins. The mesh is fixed securely using tacks and/or transfascial sutures to prevent recurrence.

One of the major advantages of laparoscopic repair is reduced postoperative pain, minimal tissue trauma, and lower incidence of wound infection compared to open repair. Additionally, patients benefit from shorter hospital stays, faster return to daily activities, and improved cosmetic results. The magnified vision provided by laparoscopy allows precise dissection, especially important in cases with dense adhesions from previous appendectomy.

At World Laparoscopy Hospital, the surgical team emphasizes patient selection, preoperative optimization, and adherence to standardized protocols. Detailed evaluation including clinical examination and imaging studies such as ultrasound or CT scan helps in planning the procedure. Postoperative care includes early ambulation, pain management, and guidance regarding activity restrictions to reduce recurrence risk.

In conclusion, laparoscopic incisional hernia repair after a previous McBurney’s incision represents a safe and effective solution for a challenging surgical condition. With advanced technology, skilled surgeons, and structured training programs, World Laparoscopy Hospital continues to set high standards in minimal access surgery. The integration of expertise and innovation ensures that patients receive comprehensive care, reduced complications, and long-term durable results.

1 COMMENTS
Dr. Vaishnavi Dhondiyal
#1
Jun 26th, 2020 9:40 am
Thank you so much.... This was so helpful. I watched your video of Laparoscopic Incisional Hernia Repair after previous Mc Burney's incision. Once again thanks. Such an amazing work.
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