Keyhole Surgery
Keyhole or laparoscopic surgery is also known as 'minimally invasive' surgery. This refers to surgery performed through small 'ports' that are 5 - 12 mm in diameter. This means several small incisions that are less painful as nothing is cut. It requires a different technique as vision is from a small TV camera and light at the end of the scope. The operating intruments are completely different from open surgery.
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Keyhole surgical repair of hernia started after the laparoscopic surgical revolution about 1990. It took many years to work out how to repair a hernia from the 'inside' as this was a radical change in approach.
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The physics of a keyhole laparoscopic repair makes good sense. Instead of trying to fix a blow out in a tyre wall from the outside, a segment of mesh is placed over the hole from the inner tube side and held in place by intra abdominal pressure. This is Pascal's principle at work & explains why laparoscopic repair may have a lower long term recurrence rate than open surgery. This is apart from the smaller incisions.
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The history of the recent intrduction of keyhole operations for inguinal hernia, the TEPP & TAPP procedures, are described under Treatment / History.