Robotic Hernia Surgery allows your surgeon to operate through small incisions that are about the size of your fingertip. Your doctor sits at a console next to you and controls tiny instruments including a camera.
The system translates your surgeon’s hand movements in real time and allows the surgeon to bend and rotate instruments with precise movement. This results in less overall tissue damage and pain for patients.
The da Vinci System is an innovative technology that enables doctors to perform surgery with greater precision and control than traditional techniques, allowing for the possibility of less pain and a faster recovery. This system, named for the Renaissance artist whose at-the-time unparalleled anatomical accuracy brought his paintings to life, is used in minimally invasive surgeries. The da Vinci system is remote controlled by a surgeon who typically sits in the same room as the patient during the procedure.
Intuitive Surgical, based in Sunnyvale, Calif., is the world leader in robotic-assisted minimally invasive surgery. The company designs, manufactures and markets the da Vinci(r) System. The system is used in a variety of procedures in many different medical specialties, including general surgery, gastroenterology, urology, gynecology and cardiothoracic surgery. Many medical school programs now include robotic-assisted surgery as part of their curriculum and require residents to have training on the da Vinci System.
There are several models of the da Vinci System. The most recent version, the da Vinci Xi (Xi stands for “evolution”), was released in 2014. The Xi is the second generation of the da Vinci System and offers expanded capabilities that allow physicians to perform more procedures than previously possible. In addition, it features enhanced instrumentation and visualization, enabling surgeons to better manage complex cases.
While clinical studies support the safety and effectiveness of surgery with the da Vinci Surgical System, it is important to remember that not everyone is a candidate for this type of procedure. Only your doctor can determine if you are a candidate and should discuss your surgical options, including non-surgical treatment options.
The da Vinci Surgical System is composed of three carts: the surgeon console, the patient side cart and the vision cart. The surgeon console contains a computer with an ergonomically designed user interface that connects to the patient-side cart and the vision cart via fiber optic cables. The patient-side cart houses a single arm that carries 3 robotic multijointed instruments and a fully articulating 3D high-definition endoscope.
The vision cart contains a camera with an advanced suite of video imaging technologies that helps surgeons see difficult-to-reach or deep structures in the body. The Xi System also includes the consolidated tremor filter, which enhances a surgeon’s ability to maneuver instruments with greater precision by automatically reducing image jitter.
What is the procedure?
Your surgeon will use the da Vinci surgical system to perform hernia surgery through a few small incisions about the size of your fingertip. Your surgeon will be seated at a console near you in the operating room, and through the console, he or she will control a camera and the instruments to perform your hernia repair.
With robotic hernia surgery, your surgeon may use the robotic system to perform a procedure called a robot-assisted transabdominal preperitoneal (r-TAPP) or a robot-assisted laparoscopic abdominal wall hernia repair (RALH). With either of these procedures, your doctor will make an incision through a tiny hole about the size of a buttonhole. Then, through a series of other small incisions, your surgeon will insert a camera and miniaturized instruments to access the site of the hernia and repair it using sutures or mesh.
When compared to traditional laparoscopic hernia repair, robotic hernia surgery produces fewer complications and faster recovery times. It also allows surgeons with limited laparoscopic experience to perform complex hernia repairs that would be difficult or impossible to do with conventional techniques.
Prior to hernia surgery, your doctor will ask you to complete a medical history form and order blood tests or imaging to ensure you’re healthy enough for the procedure. You may also need to stop taking certain medications before your surgery.
During hernia surgery, you will be given medicines to help prevent pain. You will be placed under general anesthesia for the procedure.
After the procedure, you’ll recover in the hospital for one to four hours. Your doctor may recommend you stay in the hospital longer if complications occur. You’ll be able to leave the hospital once you’re feeling well and can drive.
Recovery from hernia surgery varies from person to person, but you should be able to return to your normal activities within a few weeks. You’ll need to be careful not to strain or overdo it, and your doctor will give you specific instructions about how long you should wait before returning to work and other physical activity. You may also need to wear a support belt or take pain relievers as needed.
How is the procedure performed?
During robotic hernia surgery, your surgeon makes a single cut (several inches long for open surgery) or several small cuts (no more than an inch each). They then insert the hernia mesh and stitch together healthy tissue to create a strong barrier wall. They may also use surgical mesh to reduce the risk of a hernia returning (recurring).
Using the da Vinci System, your surgeon has a 3D high-definition view of the operating area magnified 10 times. The system translates your surgeon’s hand movements in real time, bending and rotating the instruments with greater precision than the human hand. In addition, built-in tremor filtration helps ensure smooth movement of the instruments.
In hernia repair, the robot’s wristed instrumentation and more ergonomic seated position allow your doctor to access hernia sites that may not be accessible with laparoscopic techniques. Specifically, the robotic platform allows your physician to easily place the hernia mesh in the pre-peritoneal space.
You’ll likely be given medications to prevent pain before surgery, and you’ll need to arrange for someone to drive you home afterward. Most hernia surgeries are performed on an outpatient basis, and you’ll be able to go home the same day. You’ll want to take it easy for the first few days, and you should avoid lifting or straining as much as possible.
As with any type of surgery, complications are possible. However, they’re usually less severe with robotic hernia surgery than with traditional open or laparoscopic procedures. Infection is one of the most common issues, and some patients experience heavy internal bleeding. Your doctor will review the risks and benefits of robotic hernia surgery with you before your procedure. They’ll also discuss what to expect during recovery. If you have any questions, don’t hesitate to ask. Your doctor will be happy to answer them. The hernia surgery is safe for most people, but it’s important to follow your doctor’s instructions. This will help you have a successful, quick recovery. For instance, it’s important to stop taking certain medications before surgery, including aspirin and other blood thinners.
What is the recovery process?
During robotic hernia surgery, you will be under general anesthesia. After waking up in the recovery room, your nurse will monitor you as you recover from the effects of anesthesia.
You can expect some pain and discomfort for several days after your surgery. You will be given pain relievers as needed. You will be encouraged to walk around and to stay active, but to avoid strenuous activities, lifting weights heavier than 10 pounds, or driving until your doctor tells you it is safe. Your doctor will schedule regular follow-up appointments to monitor your recovery.
Robotic hernia surgery can reduce recovery time for patients compared to traditional open hernia repair. Studies have also shown lower rates of complications and hernia recurrence following robotic hernia repairs. In addition, the procedure has the potential to lead to lower costs for hernia patients in health care systems that use a diagnosis-related group (DRG) system to determine reimbursement.
The da Vinci System allows surgeons to use less tissue during hernia repair. This results in faster healing, reduced risk of infection and a shorter hospital stay.
Hernias develop when an organ squeezes through a weakness or tear in the muscles of the abdominal wall. This can occur in the groin, belly button or in scars from previous surgeries. The goal of hernia repair is to return the herniated organ to the abdomen and to close the opening in the tissue that created the hernia.
During hernia repair surgery, your surgeon will make small incisions that are about the size of a fingertip. He or she will then sit at a console in the operating room, where he or she will control a camera and instruments to perform the surgery.
The da Vinci System’s 3D high-definition views provide your surgeon a magnified view of the surgical area, 10 times larger than what your naked eye can see. This allows your surgeon to precisely place stitches and avoid cutting or damaging surrounding tissues.
The da Vinci System’s flexible arms give your surgeon the ability to maneuver in places that would be hard to reach with other instruments, even with smaller incisions. In some cases, the surgeon can use the robot to repair hernias that cannot be fixed using laparoscopic techniques.