Robotic Surgery for Hernia Repair

Overview

How is a hernia treated?

A hernia is most often treated with surgery. The main types of surgery for hernia are:

  • Open hernia repair: An incision (cut) is made in the groin to find the “sac” containing the bulging intestine. The surgeon then pushes the hernia back into the abdomen and strengthens the abdominal wall with stitches or synthetic mesh.
  • Laparoscopic (minimally invasive) hernia repair: The surgeon makes small cuts in the lower abdomen and inserts a laparoscope (a thin tube with a tiny video camera attached). The camera sends images of the inside of the body to television screens in the operating room. The abdomen is inflated with a harmless gas (carbon dioxide), which creates space to allow the doctor to view the inside of the body. The peritoneum (the inner lining of the abdomen) is cut to allow the surgeon to see the weakness in the abdominal wall. Mesh is placed on the inside to cover the defects in the abdominal wall and strengthen the tissue.

After the procedure is completed, the small incisions in the abdomen are closed with a stitch or two or with surgical tape.

What is robotic surgery for hernia repair?

Robotic surgery is a newer technique for repairing hernias. Like laparoscopic surgery, robotic surgery uses a laparoscope, and is performed in the same manner (small incisions, a tiny camera, inflation of the abdomen, and projecting the inside of the abdomen onto television screens).

In robotic surgery, however, the surgeon is seated at a console in the operating room, and handles the surgical instruments from the console. While robotic surgery can be used for some smaller hernias, it can also be used to rebuild the abdominal wall.

Risks / Benefits

What are the advantages of robotic surgery for hernia repair?

One of the biggest differences between laparoscopic surgery and robotic surgery is that the use of the robot provides excellent three-dimensional images of the inside of the abdomen (vs. the two-dimensional images of laparoscopic surgery).

Other benefits of robotic hernia surgery include the following:

  • The surgeon can easily use stitches to sew tissue and meshes inside the abdomen.
  • The patient has tiny scars rather than one large incision scar.
  • There may be less pain after this surgery compared to open surgery.

Last reviewed by a Cleveland Clinic medical professional on 09/27/2018.

References

  • Dominguez JEE, Gonzalez A, Donkor C. Robotic Inguinal Hernia Repair. (https://onlinelibrary.wiley.com/doi/pdf/10.1002/jso.23905) J. Surg. Oncol. 2015;112:310–314. Accessed 9/13/2018.
  • Shraga S, Chang E, Radvinsky D, Sugiyama G. Robotic Inguinal Hernia Repair. (http://www.avidscience.com/wp-content/uploads/2017/06/HER-17-03.pdf) Accessed 9/13/2018.
  • Waite KE, Herman MA, Doyle PJ. Comparison of robotic versus laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair. J Robot Surg. 2016 Sep;10(3):239-44. doi: 10.1007/s11701-016-0580-1

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