Mr. K, a 52-year-old small business owner, had already been through two hernia operations before coming to Apollo Nellore. The first was an open repair years ago, following an appendix surgery. The second, a laparoscopic IPOM repair at a different hospital, had held for less than two years before a painful bulge reappeared above the umbilicus.
He was tired of it. He was also afraid of the third operation failing.
A different approach
Dr. Reddy reviewed his CT scan and clinical history. Standard re-do laparoscopic repair carried real risks given the old intraperitoneal mesh and the scar tissue around his bowel. An open component separation was an option, but recovery would be slow and painful.
The recommended approach was an eTEP repair, which places a new mesh in the space between the abdominal muscles without entering the abdominal cavity. The previous mesh is left undisturbed, and the bowel is never exposed to the dissection. It is a technically demanding operation, not routinely available outside specialist centres.
The operation
The procedure took just under three hours. Five small ports were placed laterally, the retro-muscular plane was developed from the pubis to the rib cage on both sides, the hernia defect was closed with sutures, and a large mesh was positioned in the retro-muscular space.
Mr. K walked the evening of surgery, ate a soft diet on day 2, and was discharged on day 3.
12 months later
- No visible or palpable recurrence
- No pain or pulling sensation
- Back to full work, including lifting and travel
- Follow-up ultrasound at 12 months confirmed an intact repair
In his words
"After two surgeries that failed, I almost gave up. This time was different from the start. They explained why the previous approaches had not worked and why this one would be different. The recovery was faster than my first surgery, let alone my second. A year later, I don't think about it anymore. That is the biggest change."
Patient story shared with consent. Name and identifying details have been changed.
