A number of factors have led to the recent development of a new method of repair called laparoscopic hernia repair. This technique is really an extension of a traditional mesh repair method (preperitoneal repair) that was usually used in patients who had already experienced several hernia recurrences at the same site. Previously, this mesh repair approach had required a separate incision somewhat removed from the target area. However, with the progressive development of the instruments and techniques for laparoscopic surgery, the same procedure can now be done with several relatively small incisions. This allows the surgeon to enter the space behind the hernia defect and place the mesh with minimal injury to the surface of the abdomen. The apparent advantages of this method include coverage of all the potential sites of groin hernia, which reduces the risks of recurrence while also decreasing the amount of post-surgical pain.
The potential disadvantages of the technique are: (1) a general anesthetic is required; (2) the risk of injury to blood vessels in the abdomen is increased; and (3) the long-term effects of placement of the mesh in this location remain unknown.
What about the use of a laser in hernia repair?
This is a relatively common question. It arises because, for a time, there were some surgeons marketing "Laser Hernia Repair." While a laser may have been used to make the incision and to separate the tissues, the laser really has no application in the repair of a hernia. It is impossible to perform the necessary structural repair with a laser, which is essentially a cutting tool. Hopes that somehow an incision made with a laser would significantly reduce pain have not been confirmed. This is probably because no matter how the incision is made, the majority of the post surgical pain arises from the deeper structures that require suturing.