Minimally invasive surgery makes it possible to treat many abdominal wall conditions through small incisions, avoiding, where possible, the large openings required by traditional surgery.
Today, laparoscopic and robotic techniques make it possible not only to close a hernia defect but also to perform complex abdominal wall reconstructions, restoring its:
Advantages of minimally invasive surgery?
Minimally invasive does not simply mean having smaller scars. Above all, it means:
Less postoperative painand lower need for painkillers in many patients.
Lower risk of wound complicationsparticularly infections and healing problems.
The option of placing the mesh in deep planesavoiding direct contact with the viscera.
Generally short hospital stayoften a single night in selected cases.
Faster return to daily activities
The aim is not only to reduce the impact of the operation but to achieve a solid and lasting reconstruction.
Which conditions can be treated?
Umbilical and epigastric herniaIncluding in association with rectus diastasis.
Inguinal and femoral herniaIncluding bilateral or recurrent.
Incisional herniaA hernia that develops at the site of a previous surgical incision.
Abdominal diastasisWith or without associated hernias.
Recurrent herniasAlready operated on one or more times.
Complex abdominal wall defectsRequiring advanced reconstructive techniques.
Several hernias, one operation
It is not unusual for a patient to have several abdominal wall defects at the same time, even in different areas.
Diastasisumbilical herniaepigastric herniainguinal herniasOne of the advantages of minimally invasive surgery is the possibility, in selected patients, of identifying and repairing several defects during the same operation.
Laparoscopic or robotic surgery: which to choose?
There is no single best technique for every patient.
Laparoscopy
Laparoscopy and robotics both offer minimally invasive treatment options.
Discover laparoscopic surgeryRobotics
Robotic surgery can make some complex reconstructions easier thanks to the precision of the instruments and greater freedom of movement.
Discover robotic surgeryTechniques available
- eTEP
- miSAR® and p-miSAR®
- TAR
- peTEP
- TESARpage coming soon
The choice should be guided by the reconstructive result, not by the technology used.
Personalised anaesthesia to reduce pain and side effects
Anaesthetic management also contributes to the minimally invasive nature of the operation.
In selected cases, balanced anaesthesia can be used, combining:
When clinical conditions and the procedure allow, this strategy may make it possible to avoid orotracheal intubation, using alternative airway management methods.
Pain-relief blocks also reduce the amount of opioid drugs needed during and after the operation.
This can translate into:
- Less postoperative nausea and vomiting
- Less drowsiness and fatigue related to medication
- Better pain control in the first hours after surgery
- Earlier mobilisation and a more comfortable recovery
The anaesthetic technique is decided by the anaesthetist according to the type of operation and the patient's condition, always ensuring respiratory safety.
Botulinum toxin: preparing the wall before surgery
In some patients, especially with large defects or reconstructions requiring greater tissue mobilisation, preoperative preparation with botulinum toxin injection may be useful.
How does it work?
Botulinum toxin is injected into the lateral abdominal muscles to relax them temporarily.
This can help with:
Reduced muscle tension
While the tissues are brought together and reconstructed.
Greater abdominal wall compliance
Making it easier to close some defects.
Less traction on the reconstruction in the following weeks
During the healing phase.
The effect of the toxin is temporary and can cover a significant part of the first postoperative months, the period in which fascial healing continues.
When and how is it performed?
The injection is generally scheduled about 20–30 days before surgery.
- 20–30 days beforeUltrasound-guided injection
- SurgeryWall reconstruction
- First monthsTemporary effect and fascial healing
The procedure is performed by the team's anaesthetists with ultrasound-guided injections, which allow the muscle layers to be identified precisely.
It is a well-tolerated outpatient procedure that does not require particular limitations on daily activities after treatment.
Rapid recovery, without neglecting healing
One of the main advantages of minimally invasive surgery is the possibility of resuming normal daily activities early.
Even in the most complicated cases:
- Eating
- Getting up
- Walking
within the first hours after surgery
hospital stay often limited to one night
Resuming daily activities does not coincide with complete healing of the abdominal wall.
Rehabilitation after abdominal wall surgeryAn effective reconstruction, with the least possible trauma
Every hernia has different characteristics. A specialist assessment makes it possible to identify the most suitable minimally invasive technique, plan any preoperative preparation and define the anaesthetic and rehabilitation pathway.
Book a specialist consultation to assess the options for laparoscopic or robotic treatment of your hernia.
Frequently asked questions
Can minimally invasive surgery also treat very large hernias?
Yes, complex hernias and incisional hernias can be treated with laparoscopic or robotic techniques. Feasibility depends on size, anatomical characteristics and previous operations.
Can several hernias be operated on at the same time?
Yes. Several abdominal wall defects can be repaired during a single operation, even when they are located in different areas.
Is intubation always necessary?
No. In selected patients and procedures, anaesthetic techniques that avoid orotracheal intubation can be used. The choice is made by the anaesthetist according to safety and the needs of the operation.
What is botulinum toxin used for before surgery?
It temporarily relaxes the lateral abdominal muscles, in some cases making wall reconstruction easier and reducing tension on the tissues. It is generally injected under ultrasound guidance about 20–30 days before surgery.
How long before returning to normal life?
Light daily activities can generally be resumed early. Heavy exertion and sport with loads require longer, often at least 6–8 weeks, depending on the reconstruction performed.