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Diagnostic laparoscopy as the definitive means of hernia detection?
Wes,
It’s not uncommon to perform a laparoscopy and miss a hernia. If the hernia is plugged with extraperitoneal fat, then a typical intraperitoneal exploration will not show the hernia hole. A complete exploration in the right setting should include taking down the peritoneum and looking right at the muscle itself, without anything obstructing the view.
I do not recommend placing mesh if there is no hernia. That can cause mesh-related complications and treating that is complicated and frought with risks, as Jgens points out.