A hernia is a defect in the abdominal wall, the innermost lining called fascia, through this abnormal defect, the content of the abdominal cavity comes out. It may be omentum, fat, or organ. Usually a patient feels a lump or swelling. In the groin it is called inguinal hernia, through the belly button is called umbilical hernia, through a previous incision we call it incisional hernia.
Irrespective of the location, the treatment is the same. The hernia once it has developed is progressive, it is a defect in the anatomy and needs to be corrected. Traditionally, we used to do an open operation, where a big incision is made, you cut the skin, fat, muscle, reach fascia, identify the structure which is coming out, push it back, close the fascia, then you put a mesh because tissues are weak. Then close the muscle, fat, and skin. Now we can do this laparoscopically where we use small incisions to visualize from inside the abdominal cavity, which structures are going through the defect. You pull these structures down and place the mesh on the inside of the abdominal wall. In an open operation you are putting the mesh above the defect and in laparoscopy you are putting it underneath. It is like when you are a flat tire, you want to put the patch on the inside so the pressure keeps the patch in place.
Now we can even do a robotic hernia repair. After putting the camera and a few instruments inside we can actually close the defect using a few stitches before reinforcing with the mesh. This was not possible before using just laparoscopy. The mesh is stitched all around the edge so the mesh does not move.