Pushing or Pulling? There are two ways for a surgeon to approach the herniated abdominal organs and the peritoneal sac which they have pushed through, and by which the organs will be surrounded: anteriorly and posteriorly. That is, hernia surgery can be performed using an anterior approach (Open surgery) or a posterior approach (Laparoscopic surgery). The organs need to be pushed or pulled back into the abdomen.
Anterior approaches: pushing An anterior approach means making an incision over, or very near to, the area of the abdomen where the herniating abdominal organs are escaping from the abdomen. The incision is a 5 to 10 centimeter oblique (parallel to the inguinal ligament) incision, or a 5 centimeter left-right incision. After the skin, underlying fatty tissue, layers of fascia, and external oblique aponeurosis are cut thru, and then the adherent peritoneal sac is dissected free…
