HOW ARE HERNIAS TREATED?

While most hernia conditions are not life threatening, the condition often requires a combination of lifestyle change (weight management) and surgery to avoid potential complications. If left untreated, the hernia may enlarge and cause increased pain. In rare conditions, hernia can halt blood flow to the intestine and lead to serious complications.

Every year, hundreds of thousands of people have their hernia surgically repaired.  Traditionally, hernias have been repaired through open surgery. Open surgery requires a large incision, often leaving patients with a lengthy hospital stay, an overwhelming need for pain medications, and a high risk for complications such as wound infections. The laparoscopic approach is another common method used to repair a hernia. This method requires numerous small incisions and while it is considered a minimally invasive approach, it has its own limitations, especially in the treatment of complex hernia situations.

Recent medical advancements have allowed hernias to be repaired through a minimally invasive approach using a robotic surgery platform. Robotic-assisted surgery features a 3D-HD visualization system that will guide the surgeon's movement and small surgical instruments with the capabilities of moving with greater vision, precision, dexterity, and control than the human hand. Robotic hernia repairs drastically reduce patients' time in the hospital and their risk of infections. 

ROBOTIC HERNIA SURGERY

Minimally invasive robotic surgery allows surgeons to operate through a few small incisions using tiny instruments and a 3D high-definition camera which provides crystal-clear magnified views they aren't able to see during open surgery. Fully articulating robotic arms mimic the movements of hands, allowing surgeons to have greater dexterity and control than is possible with conventional laparoscopic instruments. 

PRIMARY TYPES OF HERNIAS

• Inguinal Hernias, account for over 95% of the hernias in the groin area.  These hernias are caused when the intestines or fat push through the muscles into the inguinal canal (groin area). They can be found in both men and women, but more commonly in men. Inguinal hernias often develop as small bulge that enlarges over time. The bulge may disappear while lying down and then return with activity. 

• Umbilical Hernias are when the intestines or fat push through a weakening of the muscles in the middle of the abdomen underneath the umbilicus or navel. This location is prone to muscle weakness since it’s where the greatest stress is placed on the muscles when we do anything physical. In children these hernia often go away on their own, but in adults these hernias never get better and usually get larger over time.

• Incisional Hernias are used to describe a hernia that protrudes through an older surgery incision. Whenever patients require an incision for surgery, the muscles have to be sewn back together. No matter how these muscles are sewn together, they are never as strong as before the original surgery. Over time, the muscles can pull apart creating an incisional hernia. This can happen at the location of any prior surgery.

• Ventral/Epigastric Hernias are similar to all other hernias in that they form due to weakening of the abdominal muscles. These hernias are located between the belly button or navel, and the lower part of the breast bone. Repair of these hernias is very common.

• Femoral Hernias are a slight variation on inguinal or groin hernias. In a femoral hernia, the hole in the muscle is just under the inguinal ligament in the femoral space. The femoral region lies just below the groin. The area includes the femoral artery and vein, as well as the ‘femoral space’. This space lies just under the inguinal canal or the groin crease. Occasionally fat can push under the groin into the upper thigh. This is more common in women.

• Abdominal Wall Reconstruction is typically used to correct abdominal weaknesses caused by recurring hernias, or open wounds that are not easily resolved by other specialties. Normally, the first line of hernia correction is general surgery. However, if the repair breaks down after one or more tries, an alternative solution should be considered. 

• Hiatal Hernia occurs when the upper part of your stomach bulges through the large muscle separating your abdomen and chest (diaphragm). A small hiatal hernia usually doesn't cause problems. You may never know you have one unless your doctor discovers it when checking for another condition. However, a large hiatal hernia can allow food and acid to back up into your esophagus, leading to heartburn. Generally, self-care measures or medications will relieve these symptoms, but very large hiatal hernias might require surgery.

FREQUENTLY ASKED QUESTIONS:

How common is robotic hernia repair?

Robotic surgery has been performed over 3 million times and this number is expected to grow exponentially as surgeons and patients realize its immense benefits. Over 1,200 hospitals in the US are performing robotic hernia repair, with the technology spreading rapidly worldwide. 

What are the types of robotic hernia repair?

There are three main types of robotic hernia repair, depending on the type of hernia that has occurred: inguinal, ventral, and complex abdominal wall reconstruction. 

What kind of patient qualifies for robotic hernia repair?

Most hernia conditions can be repaired through robotic surgery but not all of them. In New Hampshire, robotic surgery is usually covered by most insurance companies. Contact Dr. Takla for more information and to find out if robotic hernia repair is the best option for you.

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