Mayo stand and back table instruments for Laparoscopic Hernia Repair surgery setup

Clamping & Occluding

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  Curved Hemostat

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  Kelly Forceps

Cutting & Dissecting

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  Laparoscopic Metz Scissor

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  Metzenbaum Scissor

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  Straight Mayo Scissor

Grasping & Holding

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  Adson Forceps

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  Bowel Grasper

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  Laparoscopic Maryland Dissector Grasper

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  Laparoscopic Wave Grasper

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  Toothed Forcep

Misc

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  0 Degree Scope

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  Camera Cord

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  Light Cord

Retracting & Exposing

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  Army-Navy Retractor

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  Hasson S Retractor

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  Senn Retractor

Suctioning

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  Suction Irrigator

Suturing & Stapling

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  Mayo-Hegar Needle Holder

What to expect during Laparoscopic Hernia Repair

Laparoscopic Hernia Repair is a minimally invasive surgical procedure performed to repair a hernia in the abdomen. A hernia occurs when an organ or tissue protrudes through a weak spot or tear in the abdominal wall. During the procedure, small incisions are made in the abdomen, and a mesh is placed to prevent recurrence of the hernia. This surgery is typically performed on an outpatient basis and has a high success rate with minimal scarring.

Position
Supine

Drapes
Folded towels around incision site, along with a lap drape.

Equipment
Camera, light cord, insufflation tubing, suction irrigator, and bovie will be passed off and clamped to the drape.

Step 1: Incisions
During a Laparoscopic Hernia Repair, the surgeon will start by making incisions where the ports will go. This is done using a 15 or 11 blade. The number of ports required is usually 2-3, and they are typically 5mm in size. Additionally, either a 12mm or 8mm port will be placed.

Step 2: Separating Tissue
To separate the tissue from the hernia inside the abdomen, the surgical team will use bowel or wave graspers. These instruments are used throughout the surgery to grasp and pull the tissue. Scissors, a Maryland, or a bullet grasper may also be used to help separate the tissue.

Step 3: Placing Mesh
Once the hernia has been emptied of bowel, a piece of mesh is usually placed to prevent reoccurrence. This is done using either a mesh tacker or suture. The mesh is held in place using these instruments to ensure it stays securely in place.

Step 4: Closing Port Sites
After the mesh has been placed, the gas will be turned off, and the port sites will be closed. The surgeon will use monocryl to close the port sites. This is commonly used for closure as it is an absorbable suture. Skin glue is usually used for a dressing as it is quick and easy to apply, and provides an excellent seal over the incision site.

The Surgery Sparknotes

1. Make incisions using a 15 or 11 blade for 2-3 5mm ports and a 12mm or 8mm port
2. Separate tissue using bowel or wave graspers, scissors, Maryland or bullet grasper
3. Place mesh with a mesh tacker or suture to prevent reoccurrence
4. Close port sites with monocryl and dress with skin glue