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.
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.
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.
The history of the recent intrduction of keyhole operations for inguinal hernia, the TEPP & TAPP procedures, are described under Treatment / History.