Hernia Repair

A hernia is a gap or space in the strong tissue that holds muscles in place. A hernia occurs when the inside layers of the abdominal muscle have weakened, resulting in a bulge or tear. In the same way that an inner tube pushes through a damaged tire, the inner lining of the abdomen pushes through the weakened area of the abdominal wall to form a small balloon like sac. This can allow a loop of intestine or abdominal tissue to push into the sac. The hernia can cause discomfort, severe pain, or other potentially serious problems that could require emergency surgery. Both men and women can get a hernia. Hernias may also occur in children. You may be born with a hernia (congenital) or develop one over time.

The common areas where hernias occur are in the groin (inguinal), belly button (umbilical), and the site of a previous operation (incisional). Other types include outer groin (femoral) and upper stomach (hiatal). Most hernias are external hernias. This means that the protrusion is toward the outside of the body and creates a bulge you can see. The protrusion in internal hernias remains inside the body. For instance, in a hiatal hernia, part of the stomach protrudes into the diaphragm, the opening to the esophagus.

Inguinal and femoral hernias are due to weakened muscles that may have been present since birth, or are associated with aging and repeated strains on the abdominal and groin areas. Such strain may come from physical exertion, obesity, pregnancy, frequent coughing, or straining on the toilet due to constipation. Adults may get an umbilical hernia by straining the abdominal area, being overweight, having a long-lasting heavy cough or after giving birth. The cause of hiatal hernias is not fully understood, but a weakening of the diaphragm with age or pressure on the abdomen could play a part.

It is usually easy to recognize an inguinal hernia. You may notice a bulge under the skin. You may feel pain or discomfort when you lift heavy objects, cough, strain during urination or bowel movements, or during prolonged standing or sitting. Other times a hernia may be detected by your doctor on a routine physical examination. The pain may be sharp and immediate or a dull ache that gets worse toward the end of the day. Severe, continuous pain, redness, and tenderness are signs that the hernia may be entrapped or strangulated. Another sign of this is if the bulge used to come and go, but now is stuck out. These symptoms are cause for concern and you should immediately contact your physician or surgeon.

A hernia does not get better over time, nor will it go away by itself. There are no exercises or physical therapy regimen that can help. A hernia can only be repaired with surgery. If you and your doctor decide that a surgical hernia repair is right for you, ask about all of your options, including a traditional open procedure with a large incision, a minimally invasive procedure and robotic-assisted surgery, which use several smaller incisions. Early studies suggest that robotic hernia repair surgery gets patients back to what matters most sooner.

Minimally Invasive hernia repair is a technique to fix tears in the abdominal wall (muscle) using small incisions, telescopes and a patch (mesh). Minimally Invasive repair offers a shorter return to work and normal activity for most patients. Most patients need little or no prescription pain medications after minimally invasive repair and go home the day of surgery.

Robotic surgery offers even more advantages over minimally invasive surgery. The Da Vinci surgical robot used at Riverwood Healthcare Center allows surgeons to see with a magnified, 3D view and use advanced instruments, which results in even more precise surgery. The surgeon is always in full control of the robotic system. Results may vary, but the value of robotic-assisted hernia repair is less pain during recovery and a faster return to work and normal activities than those who have an open procedure.

Using a da Vinci® robot, the surgeon makes a few small incisions in the abdomen using long, thin instruments and a tiny camera. The camera sends images to a video monitor in the operating room to guide your surgeon during the operation. The robot is designed to provide surgeons with enhanced capabilities, including high definition 3D vision and a magnified view. The surgeon controls the robot, which translates his or her hand movements into smaller, precise movements of tiny instruments inside the body. The robot cannot act on its own. Surgery is performed entirely by the surgeon.

It’s used by 100% of the top-ranked hospitals in the United States for cancer, urology, gynecology, and gastroenterology. Every 60 seconds, a surgeon starts a da Vinci® robotic-enhanced procedure somewhere in the world.

Following a minimally invasive or robotic hernia repair operation, you will be transferred to the recovery room where you will be monitored for 1-2 hours until you are fully awake. Once you are awake and able to walk, drink liquids, and urinate, you will be sent home. With any hernia operation, you can expect some soreness, mostly during the first 24 to 48 hours. You are encouraged to be up and about the day after surgery. With minimally invasive or robot-assisted hernia repair, most patients are able to get back to their normal activities within a week. These activities include showering, driving, walking up stairs, lifting, working and engaging in sexual intercourse.