With the assistance of a robot guided by a surgeon’s trained hands, hernia repair can now be accomplished with less pain and faster recovery. McLeod Surgeon Amanda Turbeville, MD, describes how her hands guide a surgical robot, leading to a faster recovery and less lingering pain:
Here’s a summary of Dr. Turbeville’s comments:
A hernia is basically a bulge of tissue or organs through a weakening of the abdominal muscles. The most common sites for hernias are in the groin, the bellybutton, or in areas with previous surgical scars.
Some signs and symptoms of hernia? Often, people notice a dull achy pain, either in the groin or around the bellybutton. It can be associated with a bulge. Sometimes that bulge is more noticeable when you stand. When you lay flat, it disappears. More concerning symptoms would be changes in your bowel habits. Nausea, vomiting — those are things that you shouldn’t wait for. You should call a doctor immediately if you have those kinds of symptoms. But a small bulge in the groin or around the bellybutton and some achy dull pain are the most common symptoms of a hernia.
There are three types of hernia repairs. The first is the traditional open hernia repair. And then there are the two minimally invasive repairs, both laparoscopic and robotic. With open hernia repair, the surgeon makes a large incision over the area of the weakness. They dissect the hernia away from the surrounding tissues, push the hernia or the organ back into the abdominal cavity where it belongs and reinforce that weakness with mesh and stitches. The minimally invasive procedures are very similar in that it gives you the same outcome. The whole idea is to put the organ is put back where it belongs, repairing the hernia and the weakness. But they do it through smaller incisions. So, with a laparoscopic hernia repair, the surgeon makes 3 to 5 small incisions across the abdomen. They’re about the size of a pencil eraser. One of those has a camera. They operate through the other port sites or incision sites. With robotic surgery, it’s very similar except that the surgeon is in control of the camera and the small robotic arms. They are able to replicate the movements of the human hand. So, you can replicate the wrist movements and manipulate the tissue with using both hands at the same time. It makes it a little bit easier to manipulate the tissue. The whole idea of robotic-assisted surgery is to repair the hernia through smaller incisions.
We’ve started using the robot for our minimally invasive cholecystectomies. And the reason for that is we have the 3D view. So, we have a really good idea of what’s going on inside the abdomen. We have very precise movements with the wristed instruments that allow us to mimic our natural movements that we would use during open surgery, but we have the benefit of being able to do it through smaller incisions.
The patient benefits of robotic-assisted gallbladder surgery are similar to all robotic surgery. The biggest is reduced postoperative pain, which requires less postoperative pain medication. Generally, people take pain medication for a day or two after surgery and then they’re able to move on to either Advil or Tylenol. At the same time, they’re able to get back to their activities of daily living more quickly. You leave the hospital an hour or two after surgery. You walk yourself to your car. You walk yourself into your house. You can shower, ride in a car and do all of your normal activities. You still hold off on heavy lifting or strenuous activity for a week or so after surgery, but you’re able to get back to your normal life pretty quickly.