GARTH H. BALLANTYNE, M.D., M.B.A
BOARD CERTIFIED IN:
GENERAL SURGERY & COLON AND RECTAL SURGERY
OFFICE: 4 SHAW'S COVE, NEW LONDON, CT 06320
SURGEON IN CHIEF
LAWRENCE & MEMORIAL HOSPITAL
NEW LONDON, CT 06320
PRACTICE LIMITED TO LAPAROSCOPIC SURGERY
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This page last updated:
September 11, 2010 11:55 AM
LAPAROSCOPIC INGUINAL HERNIA REPAIR
Each year about 600,000 hernia-repair operations are performed in the United States.
Until recently, however, all were performed as traditional, "open" procedures requiring a
large incision in the lower abdomen. The result was significant pain for patients.
Today, the minimally invasive technique of laparoscopic surgery can be used to repair the
most common types of hernias. Although both traditional and laparoscopic hernia surgery
are performed on an outpatient basis, patients treated laparoscopically seem to
experience more rapid healing and far less pain during recovery. They can return to
normal activity, including work, after only a few days, while recovery from traditional
hernia repair can be a three- to five week process.
The laparoscopic approach can be used to repair direct and indirect inguinal (groin)
hernias and femoral (below the groin) hernias. Some hernias located in other parts of the
abdominal wall can be repaired laparoscopically as well.
Because laparoscopy requires extensive and specialized training, only a small number of
surgeons throughout the country are qualified to perform these procedures. Dr.
Ballantyne, at the Center for Advanced Laparoscopic Surgery at St. Luke's-Roosevelt
Hospital Center, is one of them. The Center is equipped with the latest laparoscopic
technology, including three-dimensional imaging equipment and the most advanced
ultrasound instruments in use anywhere.
THE LAPAROSCOPIC SURGERY PROCEDURE:
A hernia occurs when the abdominal wall weakens and the inner lining of the abdomen
pushes through the weakened area, forming a sac. To correct this problem, the surgeon's
goal is to patch the abdominal wall in a way that will permanently strengthen it, precluding
the possibility of another hernia later.
Minimally invasive surgery for hernia repair begins with three or four small incisions
through which the surgeon inserts trocars-narrow, tube-like devices. Through one trocar,
the surgeon inserts a laparoscope, which is a telescopic videocamera that provides a
magnified view of internal anatomical structures. Surgical instruments for cutting and
gripping are inserted through the other trocars. Dr. Ballantyne watches on a video
monitor as he manipulates these instruments inside the abdomen.
In a laparoscopic hernia repair procedure, Dr. Ballantyne first pulls the hernial sac back
into the abdominal cavity, exposing the defect in the abdominal wall. This weakened
portion is then covered with a mesh patch. Laparoscopy allows Dr. Ballantyne to place
and anchor the patch on the inside of the abdominal wall, taking advantage of the natural
outward pressure of the abdomen to secure the repair and promote healing. (In contrast,
the patch must be placed on the outside of the abdominal wall in the traditional open
Because a laparoscopic hernia repair is stronger than a repair performed traditionally, the
hernia is less likely to recur. In fact, patients with a recurring hernia may find the
laparoscopic approach necessary to permanently eliminate ruptures in that area of the
Although most hernia procedures are performed under general anesthesia, in certain
cases, patients can be operated on under regional anesthesia.
At the Center for Advanced Laparoscopic Surgery, patients are carefully evaluated to
determine whether a minimally invasive hernia repair is the best approach for them. Our
experience is that most patients benefit from laparoscopy; however, for some patients,
the traditional procedure is recommended.
Once the operation is scheduled, St. Luke'sRoosevelt Hospital Center will evaluate your
health and perform routine blood tests. Before the operation you will also meet with an
anesthesiologist or nurse anesthetist who will ask questions about previous surgeries and
explain the anesthesia procedure.
Because laparoscopic hernia repair is usually performed under general anesthesia, you
cannot eat or drink anything after midnight the day before the surgery. You will be
admitted to the hospital the same day as your surgery.
In the hours following your laparoscopic hernia operation, you will experience some pain
from the small incisions your surgeon made to perform the procedure. Within three to five
hours, you will be discharged from the hospital with a family member or other escort.
At home you will be able to take care of yourself. In two or three days, you can return to
work and your normal routine. If you exercise, you can also resume a fitness program and
sports competition. After a few months, the surgical incisions will be barely visible.
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Copyright 1996, Garth Hadden Ballantyne, M.D., P.C. All rights reserved.
50 East 69th Street, New York, New York 10021 (212)-249-2626 or (800)-LAP-SURG