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Laparoscopic repair of a recurrent incisional hernia involves a minimally invasive surgical technique aimed at correcting a hernia that has reoccurred at the site of a previous abdominal incision. An incisional hernia is characterized by a protrusion of tissue through a defect in the abdominal wall, which occurs due to inadequate healing of a surgical wound. This type of hernia can be particularly challenging to manage because the abdominal wall tissue is often already compromised, being thin and stretched from prior surgical interventions. The procedure may include the insertion of a mesh, which is a common practice to reinforce the abdominal wall and reduce the likelihood of future hernias. In cases where the hernia is incarcerated or strangulated, the surgical approach becomes more complex, as it requires careful handling of the affected bowel or tissue to prevent further complications. The laparoscopic method allows for a thorough examination of the abdominal cavity, enabling the surgeon to address adhesions, evaluate the hernia's extent, and perform the necessary repairs with minimal disruption to surrounding tissues.
© Copyright 2025 Coding Ahead. All rights reserved.
The laparoscopic surgical repair of a recurrent incisional hernia is indicated in the following situations:
The laparoscopic repair of a recurrent incisional hernia involves several critical steps to ensure a successful outcome. First, a small incision is made at a location away from the previous surgical site to minimize complications. A trocar is then inserted to establish pneumoperitoneum, which is the inflation of the abdominal cavity with gas to create a working space. Following this, a laparoscope is introduced, allowing the surgeon to visualize the internal structures. Additional portal incisions are made under direct vision to facilitate the insertion of surgical instruments. The surgeon then proceeds to lyse any adhesions that may be present, which are bands of scar tissue that can complicate the procedure. The abdominal wall is thoroughly examined to assess the extent of the hernia, and the edges of the hernia defect are cleared of peritoneum and fat to prepare for repair. The hernia contents are carefully reduced back into the abdominal cavity. Depending on the condition of the hernia defect, it may be closed using primary sutures, or a mesh insert may be required for reinforcement. If mesh is necessary, the defect is measured, and the mesh is cut to the appropriate size, positioned over the defect, and secured to the abdominal wall using tacks or sutures. Once the repair is complete, the laparoscope and instruments are removed, the pneumoperitoneum is released, and the portal incisions are closed to complete the procedure.
After the laparoscopic repair of a recurrent incisional hernia, patients are typically monitored for any immediate complications. Post-procedure care may include pain management and instructions for activity restrictions to promote healing. Patients are advised to avoid heavy lifting and strenuous activities for a specified period to prevent strain on the surgical site. Follow-up appointments are essential to assess the healing process and ensure that no complications, such as infection or recurrence of the hernia, occur. The expected recovery time can vary based on individual patient factors and the complexity of the surgery, but many patients can return to normal activities within a few weeks.
| Short Descr | LAP INC HERN RECUR COMP | Medium Descr | LAPS RPR RECURRENT INCAL HRNA NCRC8/STRANGULATED | Long Descr | Laparoscopy, surgical, repair, recurrent incisional hernia (includes mesh insertion, when performed); incarcerated or strangulated | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P8I - Endoscopy - other | MUE | Not applicable/unspecified. | CCS Clinical Classification | 86 - Other hernia repair |
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