Robotic Ventral Hernia

What is a ventral hernia

  • When a ventral hernia occurs, it usually arises in the abdominal wall where a previous surgical incision was made. In this area the abdominal muscles have weakened; this results in a bulge or a 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 balloon-like sac. This can allow a loop of intestines or other abdominal contents to push into the sac. If the abdominal contents get stuck within the sac, they can become trapped or "incarcerated." This could lead to potentially serious problems that might require emergency surgery.
  • Other sites that ventral hernias can develop are the belly button (umbilicus) or any other area of the abdominal wall.
  • rA hernia does not get better over time, nor will it go away by itself.
  • A hernia is usually recognized as a bulge under your skin. Occasionally, it causes no discomfort at all, but you may feel pain when you lift heavy objects, cough, strain during urination or bowel movements or with prolonged standing or sitting.
  • The discomfort may be sharp or a dull ache that gets worse towards the end of the day. Any continuous or severe discomfort, redness, nausea or vomiting associated with the bulge are signs that the hernia may be entrapped or strangulated. These symptoms are cause for concern and immediate contact of your physician or surgeon is recommended.
  • An incision in your abdominal wall will always be an area of potential weakness. Hernias can develop at these sites due to heavy straining, aging, injury or following an infection at that site following surgery. They can occur immediately following surgery or may not become apparent for years later following the procedure.
  • Anyone can get a hernia at any age. They are more common as one gets older. Certain activities may increase the likelihood of a hernia including persistent coughing, difficulty with bowel movements or urination, or frequent need for straining.
  • Minimally invasive Da Vinci® procedure provides wristed instruments that bend further than the human hand allowing your surgeon to operate with increased precision and control.
  • Results often also include
  • Less post-operative pain
  • Shortened hospital stay
  • Quicker return to regular diet
  • Quicker return to normal activity

Only after a thorough examination can your surgeon determine whether a robotic ventral hernia repair is right for you. The procedure may not be best for some patients who have had extensive previous abdominal surgery, hernias found in unusual or difficult to approach locations, or underlying medical conditions. Be sure to consult your physician about your specific case.

  • Most hernia operations are performed on an outpatient basis, and therefore you will probably go home on the same or following day that the operation is performed.
  • Preoperative preparation includes blood work, medical evaluation, chest x-ray and an EKG depending on your age and medical condition.
  • After your surgeon reviews with you the potential risks and benefits of the operation, you will need to provide written consent for surgery.
  • It is recommended that you shower the night before or morning of the operation.
  • Your surgeon my request that you completely empty your colon and cleanse your intestines before surgery. Usually, you must drink a special cleansing solution. You may be requested to drink clear liquids, only, for one or several days prior to the operation.
  • After midnight the night before the operation, you should not eat or drink anything except medications that your surgeon has told you are permissible to take with a sip of water the morning of surgery.
  • Drugs such as aspirin, blood thinners, anti-inflammatory medications (arthritis medications) and Vitamin E will need to be stopped temporarily for several days to a week prior to surgery.
  • Diet medication or St. John's Wort should not be used for the two weeks prior to surgery.
  • Quit smoking and arrange for any help you may need at home.
  • You usually arrive at the hospital the morning of the operation.
  • A qualified medical staff member will typically place a small needle or catheter into your vein to dispense medication during the surgery. Often pre-operative medications, such as antibiotics, may be given.
  • Your anesthesia will last during and up to several hours following surgery.
  • Following the operation, you will be taken to the recovery room and remain there until you are fully awake.
  • Few patients may go home the same day of surgery, while others may need admission for a day or more post-operatively. The need to stay in the hospital will be determined according to the extent of the operative procedure and your general health.

In a small number of patients the robotic method cannot be performed. Factors that may increase the possibility of choosing or converting to the "open" procedure may include obesity, a history of prior abdominal surgery causing dense scar tissue, inability to visualize organs or bleeding problems during the operation.

The decision to perform the open procedure is a judgment decision made by your surgeon either before or during the actual operation. When the surgeon feels that it is safest to convert the robotic procedure to an open one, this is not a complication, but rather sound surgical judgment. The decision to convert to an open procedure is strictly based on patient safety.

  • Patients are encouraged to engage in light activity while at home after surgery. Your surgeon will determine the extent of activity, including lifting and other forms of physical exertion. Follow your surgeon's advice carefully.
  • Post-operative discomfort is usually mild to moderate. Frequently, patients will require pain medication.
  • If you begin to have fever, chills, vomiting, are unable to urinate, or experience drainage from your incisions you should call your surgeon immediately.
  • If you have prolonged soreness and are getting no relief from your prescribed pain medication, you should notify your surgeon.
  • Most patients are able to get back to their normal activities in a short period of time.
  • Occasionally, patients develop a lump or some swelling in the area where their hernia had been. Frequently this is due to fluid collecting within the previous space of the hernia. Most often this will disappear on its own with time. If not, your surgeon may aspirate this with a needle in the office.
  • You should ask your physician when and if you need to schedule a follow-up appointment. Typically, patients call to schedule follow-up appointments within 2-3 weeks after their operation.
  • Although this operation is considered safe, complications may occur as they might occur with any operation, and you should consult your physician about your specific case. Complications during the operation may include adverse reactions to general anesthesia, bleeding, or injury to the intestines or other abdominal organs. If an infection occurs in the mesh, it may need to be removed or replaced. Other possible problems include pneumonia, blood clots or heart problems if someone is prone to them. Also, any time a hernia is repaired it can come back.
  • The long-term recurrence rate is not yet known. The early results indicate that it is as good as the standard or traditional approach. Your surgeon will help you decide if the risks of robotic ventral hernia repair are less than the risks of leaving the condition untreated.
  • It is important to remember that before undergoing any type of surgery, whether laparoscopic, robotic, or traditional, you should ask your surgeon about his/her training and experience.

Be sure to call your surgeon if you develop any of the following:

  • Persistent fever over 101 F (39 C)
  • Bleeding
  • Increased abdominal swelling or pain
  • Pain that is not relieved by your medications
  • Persistent nausea or vomiting
  • Chills
  • Persistent cough or shortness of breath
  • Drainage from any incision
  • Redness surrounding your incisions

University Surgeons Associates

1934 Alcoa Hwy, Building D, Suite #285 Knoxville, TN 37920 865-305-9620 Fax: 865-525-3460