Hernias occur when an organ or fatty tissue pushes through a weak muscle or connective tissue spot. They can occur in the abdomen, groin, diaphragm, or around the belly button.
Surgeons use da Vinci surgical technology to fix hernias through small incisions. The system translates the surgeon’s natural hand, wrist, and finger movements into precise instrument movements inside the body. Click the Robotic Hernia Surgery to learn more.
Robotic hernia surgery allows for the surgeon to perform hernia repair through smaller incisions, which may lead to fewer complications and a shorter recovery for the patient. The type of hernia that is repaired will influence how extensive the recovery is, and the surgeon will determine if there are activity restrictions. Recovery may take two to four weeks, depending on the extent of the hernia repair and the surgeon’s recommendation for recovery.
During robotic hernia surgery, the surgeon sits at a console in the operating room and controls a set of handheld surgical tools that are inserted through small cuts, or incisions, less than an inch long. The surgeon uses these tools to operate, much like a laparoscopic procedure, but with more precision and control.
The Da Vinci robot has improved upon the capabilities of traditional laparoscopic hernia surgery and provides surgeons greater instrument control, precision and visualization for hernia repairs. As a result, patients experience quicker recoveries with less pain and need for narcotic pain medications. They are also discharged sooner than with traditional open surgery and do not have to stay in the hospital for multiple days.
Some hernia repairs require more sewing and dissection, which is more difficult to do with a laparoscope, but can be done with the da Vinci robot because of its increased capabilities and improved visualization. The wristed instruments allow the surgeon to maneuver and create stronger sutures, which leads to a more aesthetically pleasing repair.
In addition to being able to use more advanced and precise instruments, robotic hernia surgery allows for less post-operative pain because of the smaller incisions. It is important to remember that while robotic hernia surgery offers many benefits, it is not the right option for everyone. The surgeon will discuss treatment recommendations for each individual with the patient.
This retrospective study analyzed all elective transabdominal robotic inguinal hernia repair cases performed by 10 surgeons in two hospitals at one healthcare system from July 2015 to September 2018. The patients were divided into early and late experience groups based on their first 20 cases. The early group was compared to the late group with respect to intra-operative time and direct operative cost, which were adjusted for operative heterogeneity based on surgeons’ years in practice and previous laparoscopic hernia repair experience.
Safety
A hernia is a bulge or protrusion of an organ or fatty tissue through a weakened area in the muscle of the abdominal wall. Symptoms include pain, aching and heaviness in the affected area. Hernias are common and most people can benefit from hernia repair surgery. With robotic hernia surgery, doctors can perform the procedure with less invasive techniques, which reduce risks and complications such as wound infections and long recovery times.
With traditional open surgery, surgeons make a larger incision to access the abdomen and hernia. Patients often require general anesthesia and face a longer recovery time than hernia patients who undergo laparoscopic procedures. In addition, patients undergoing conventional hernia repair may experience more hernia recurrences than those who undergo robotic hernia surgery.
During robotic hernia surgery, surgeons use three ports: a 12 mm port near the belly button and two 8 mm ports on either side of the stomach. The surgeon then maneuvers the robot’s “hands” to repair the hernia and reattach weakened muscles back into place. Special 3D mesh is then placed for strength support.
The robotic procedure is similar to laparoscopic hernia repair, but with a few differences. The surgeon uses a camera to visualize the surgery site and maneuvers the robotic instruments, which are smaller and more flexible than surgical tools used in traditional open surgery. During robotic hernia repair, your doctor may inflate the abdomen with a harmless gas (carbon dioxide) to make it easier to see inside the abdomen.
Once the hernia is repaired, your surgeon will close the incisions. Most patients are able to leave the hospital on the same day.
In qualified hands, the benefits of robotic hernia surgery outweigh the risks. However, it is important to consider your specific health history and current medical needs before deciding on robotic hernia surgery.
The first step is to talk with a hernia specialist and find out if you are a candidate for robotic hernia surgery. The hernia surgeon will review your medical history, examine the abdomen and hernias and perform tests to ensure that robotic hernia surgery is right for you.
Risks
As with any surgical procedure, there are risks associated with robotic hernia surgery. These include infection, bleeding and damage to nearby tissues. Surgeons follow strict sterilization protocols to reduce the risk of infection, and antibiotics may be given as a preventive measure before and after the procedure. Bleeding is also a risk, but this can usually be controlled with medications or additional surgery. Infection and bleeding are less common with robotic hernia surgery than with traditional laparoscopic or open surgery.
The Da Vinci system offers wristed instruments that bend farther than the human hand, giving surgeons increased precision and control over delicate tissue areas. However, as with any medical device, there is a small chance of equipment malfunction during hernia surgery. Robotic systems undergo regular testing and calibration to ensure that all components are functioning properly, and surgeons are trained to manage any problems that might arise during a surgical operation.
During the robotic hernia repair, your surgeon will be seated at a console away from your bedside, visualizing the surgical field through a viewfinder. This eliminates the need for surgeons to hold their necks in a static, abducted position during long operations, which can cause shoulder pain and stiffness [1].
Studies comparing outcomes of robotic hernia surgery to those of traditional, laparoscopic, and open surgery have shown that the procedure is associated with lower rates of hernia recurrence and shorter lengths of postoperative hospital stays. However, longer operative times have been reported, most likely due to the increased docking time required to switch out instruments.
Despite the lower risk of complications, hernias can still recur, especially in patients with certain risk factors such as obesity and weakened abdominal wall muscles. Patients can help reduce the risk of hernia recurrence by maintaining a healthy weight, avoiding heavy lifting, and following post-surgery guidelines. In addition, mesh used in hernia repairs can be susceptible to complications such as migration or rejection. It is important to understand these potential risks and discuss them with your surgeon before having hernia surgery. This will allow you to make an informed decision about the best option for you.
Recovery
When left untreated, hernias can cause pain and discomfort. They can also become larger and lead to complications such as strangulation. In extreme cases, the hernia may completely cut off blood flow to the tissue, requiring emergency surgery. Robotic hernia repair is a minimally invasive option that can be performed in just one session, reducing recovery time and pain.
In most cases, patients go home on the same day as their hernia surgery. They will likely feel groggy from the anesthesia, and the incision sites will be sore. The doctor will provide NSAIDs to control any pain after surgery. It is important to take it easy for the first few days after hernia surgery, and avoid strenuous activities and lifting heavy objects. Most adults can return to work within a week of their hernia operation, and most can resume their daily routines with a few weeks.
Following hernia surgery, patients should drink lots of water and eat high-fiber foods to promote healthy bowel movements. It is important to avoid hard or fatty foods, and patients should also use the restroom frequently to prevent constipation. Most people can resume simple exercise such as walking, as soon as they are comfortable enough to do so. It is best to avoid any strenuous or weight-lifting activities, though, as these can strain the hernia incision site.
If you have trouble urinating, or if your hernia becomes obstructed after surgery, contact the doctor right away. It is a rare occurrence, but sometimes the hernia can be so large that it causes difficulty passing urine. If this occurs, you will need to have a catheter inserted to decompress the bladder and relieve the pressure on the tissue.
You should also avoid smoking or consuming alcohol, as these can increase the risk of complications and slow the healing process. Patients should also be sure to attend all follow-up appointments with the hernia surgeon to make sure the hernia has healed fully.
