Today, people who suffer from a hernia have more than one repair option. Hernias still must be repaired surgically, but now you can avoid open surgery by choosing laparoscopic or robotic surgery.
The benefits of these minimally invasive surgical techniques include a shorter stay in the hospital, fewer surgical site infections, as well as lower morbidity and a quicker return to function compared to open procedures.
What causes a hernia?
Hernias occur when tissue bulges through a weakened area of the abdominal wall. It may be a lump that you can see and feel, or it may be abdominal pressure. If it’s not repaired, a hernia will never heal or improve. Most will get bigger and worse with time.
An estimated 5 to 7% of all adults suffer from hernias each year. Most result from physical activity, but other activities can contribute to or cause a hernia.
These activities can increase pressure on the abdominal wall:
- Lifting heavy objects
- Constipation
- Persistent coughing
- Obesity
- Straining to urinate
- Smoking
- Poor nutrition
- Physical exertion
Types of hernias
Hernias can affect people of all ages, from newborns to seniors. All hernias are caused by a weakened abdominal wall.
These are the types of hernias:
- Inguinal occurs in the groin
- Femoral also occurs in the groin or inner thigh
- Umbilical most often occurs in the navel or near the bellybutton
- Ventral occurs in the middle part of the body, but not the bellybutton
- Incisional occurs anywhere a previous surgery has taken place in the body (incisions weaken muscles, which never regain their full strength)
In the U.S., an estimated 350,000 ventral and 600,000 inguinal repairs are performed each year with the majority – 60 to 70% – done with an open surgery technique. Most hernia repair involves the use of mesh that is attached to the muscle wall to prevent tissue from protruding.
Because of advances in technology and training over the past decade, laparoscopy and robotic surgery have enabled quicker recovery from both ventral and inguinal hernia repairs.
"Patients take fewer pain pills and return to work and recreational activities sooner," says Mohan Ramalingam, MD, a general surgeon trained in minimally invasive surgery and an independent member of the HonorHealth medical staff. "Our newest robot represents state-of-the-art technology for the treatment of abdominal wall hernias, both simple and complex,"
Laparoscopic and robotic repair
In both laparoscopic and robotic hernia repair, the surgeon makes small cuts in the abdomen to insert a laparoscope, a thin tube with a tiny video camera. The camera enables the surgeon to see inside the body.
In laparoscopic surgery, the surgeon sees two-dimensional images on a screen in the operating room. In robotic surgery, the surgeon sees three-dimensional images and operates at a console near the patient. Directed by the surgeon, the robot uses surgical instruments to sew tissue and place mesh inside the patient’s abdomen. Instead of a large scar from an open surgery incision, patients have only tiny scars that heal quickly and with less pain.
Robotic surgery costs the same as laparoscopic surgery and is covered by most types of insurance. Both procedures are done as outpatient surgeries, and patients go home the same day. After a follow-up visit one week after surgery, most patients return to work within a week or two with some weight-lifting restrictions.
"Our robotic surgeons are thoroughly trained in this robotic surgery, completing computer modules and hands-on training to obtain certification," Dr. Ramalingam says. "Then they work with the manufacturer of robotic instruments during their initial surgeries to ensure the safest and best possible outcomes for their most important clients, their patients."