Q: I am having right side inguinal hernia. 1. How to wear the belt, exact location; will it help and any other precautions. 2. Outside India they do not use laparoscopy now rather use PerFix plug or Kugel repair which is done under local anesthesia and recovery is really fast with less chances of recurrence. Moreover, it involves minimal surgery than laparoscopic. Is it done in India also? Kindly suggest most minimal surgery (apart from laparoscopy) or no surgery option for hernia.

A:Hernias may be repaired by laparoscopy, or by open surgery. In both forms a mesh made of polypropylene is inserted to strengthen the repair. The recurrence rates after open surgery are nearly zero, and are better than for laparoscopic surgery today, although some surgeons will contest this statement. However, both open and laparoscopic surgery are associated with minimal invasion, and there is little to choose between the two. My own recommendation is for open surgery if you have a single-sided hernia, but laparoscopic surgery is by no means a bad choice. Laparoscopy is more expensive. The plugs you describe are modifications of existing mesh repairs. If they offer any advantage, it is very slight. If I had a hernia I would walk to my surgeons office and ask for an early open repair: the results are so good that it is difficult to document the benefits of modifications. Hernia belts are bad, do not use them. They delay the treatment, and can damage tissue locally. Get operated, the surgery is simple and safe.