Dr Yogesh Palshetkar, Senior Consultant – General Surgery and Dr Tejas Savdekar, Consultant-General Surgery, Fortis Hospital, Kalyan, discuss how minimally invasive techniques are changing hernia treatment, the importance of selecting the right surgical approach and the role of continued training in improving surgical outcomes
A hernia might first appear like a harmless bulge but in certain cases; a hernia could be painful and troublesome too. The good news is that the modern hernia treatment procedure does not require major incisions and long recovery time because the recent advance of Minimally Invasive Surgery (MIS) allows treating hernia in a new way.
A hernia happens due to the appearance of a hole in a weak muscle through which internal organs or tissues protrudes. Hernias can happen in various regions of the human body and include groin hernias. Even though a hernia in the beginning of its development causes no pain, there are certain signs indicating its presence including discomfort, visibility of a bulge, pain when a person coughs or lifts something, etc.
There have been many advancements in hernia treatment, but the most significant one is minimally invasive surgery. Instead of one major incision, the surgeon makes several small incisions and uses specialised instruments to repair the hernia.
However, the minimal invasive procedure does not only consist in making small incisions; it demands profound knowledge of anatomy, proper planning, and a high level of surgical skill. Various types of hernias may necessitate the use of various operations, and it is necessary to choose the appropriate one based on the patient’s health condition.
The techniques that are utilized in case of inguinal hernia repair include TAPP and TEP operations. Another advanced approach, eTEP, can also be used in selected cases. While these terms may sound complicated to patients, the principle is straightforward: the surgeon works through small openings to reach and repair the weakened area while aiming to minimise unnecessary tissue disruption.
This is also why continuous learning among surgeons is so important. Surgical techniques continue to evolve, and sharing experiences allows doctors to understand not only how a procedure is performed, but also when it is appropriate, how to deal with challenges and how to make sound decisions during surgery.
Recently, we at Fortis Hospital, Kalyan, in association with the Surgical Society (Thane) and The Gastro-Intestinal Foundation (Thane), conducted a specialised MIS Hernia Workshop bringing together more than 50 surgical experts. We had the opportunity to drive the programme as Course Convenor, with Dr Tejas Savdekar, Consultant – General Surgery, Fortis Hospital, Kalyan, serving as the Co-Convenor.
The workshop included live operative demonstrations, interactive discussions and a focused masterclass on minimally invasive inguinal hernia surgery. Surgeons discussed applied anatomy, TAPP, TEP and eTEP techniques, procedure selection and management of complications. Such academic exchanges are valuable because they bring practical surgical experience into the discussion rather than limiting learning to textbooks or theoretical sessions.
For patients, the larger message is that hernia treatment is becoming increasingly personalised. Not every patient will require the same procedure, and minimally invasive surgery may not be suitable in every situation. The choice will depend upon parameters like nature of the hernia, size of the hernia, general well-being of the patient, past surgeries, etc.
Patients should therefore not delay medical consultation simply because a hernia is not painful. A small bulge can sometimes progress, and timely evaluation allows the condition to be assessed before complications develop.
The goal of modern hernia surgery is not simply to repair a defect. It is to do so safely, appropriately and with as little disruption to the patient’s life as possible. Considering the developments in laparoscopic surgery and the cooperation between the surgeons, we are heading towards a surgical approach that not only aims for success in treating the patient but also ensures that the patient leads his normal life after the surgery.