Robotic Hernia Surgery in Delhi, India

Robotic surgery is a new way to treat hernias. Using robotic arms is better than the usual laparoscopic methods because the robot can move more easily. This helps the surgeon do tricky things like repairs and stitches inside the body very carefully and without much trouble. Also, the robot lets the surgeon see the inside of the belly in 3D and high-definition.

When is surgery needed?

Hernias almost always require surgery. They do not respond to medication and never heal on their own. All hernias require to be repaired effectively to get relief from the symptoms and the possibility of a subsequent surgical emergency. Hernias can become a surgical emergency if its contents become confined or strangulated.

Diagnosis

Most hernias can be diagnosed with a physical examination by a doctor or a specialist. Some imaging techniques like an ultrasound, CT scan, or MRI may be needed to confirm the diagnosis of abdominal hernias. Hiatal hernias, however, additionally require imaging techniques such as upper GI scans done in radiology or by upper endoscopy.

Treatment

Robotic hernia surgery can be carried out under general anaesthesia, which means the patient is asleep and feels no pain.

• The surgeon sits at a console in the operating room and deals with the surgical instruments from the console. Once the anaesthesia has taken effect, the operating surgeon makes incisions or small cuts over the abdomen and makes provision for the robotic scopes to enter the surgical site through a port; other surgical ports are used for surgical instruments. The abdomen is inflated, and everything inside is projected onto television screens.
• Robotic surgery can be performed for smaller hernias and rebuild the abdominal wall. The main aim of hernia surgery is for a robust repair with minimal complications.
• Minimally invasive hernia surgery helps treat the issue with the least risk for the usual complications confronted with open surgery. The latest techniques in minimally invasive hernia surgery are increasing compared with the previous open methods. More complex abdominal wall hernias are now treated with robotic surgery, given the benefits of promising results for patients with complicated abdominal hernias. Such patients may require a strong anatomic repair but can still be treated from a minimally invasive approach.

Hernias can be either the enlargement of an anatomic defect or the development of a new defect in a compromised tissue. The surgeon may use a mesh over the hernia to repair it and close it with sutures.

Who Are the Best Candidates for Surgery?

The eligibility for robotic hernia surgery depends on the following factors:

• The age of the patient should be more than 18 years.
• Diagnosis of hernia should be confirmed using different imaging techniques.
• The patient should be otherwise healthy, and if not, appropriate measures to manage the underlying conditions should be applied.
• A correct medical history is inclusive of all information about the patient's past medical records, allergies, and existing medication should be considered.

Who Should Not Consider Surgery?

Patients who are not healthy and suffer from debilitating diseases may take a long time for the healing process to complete.

How to Prepare for Keyhole Surgery?

• It's a good idea to wear loose clothes and a shirt with buttons when you go to the hospital for surgery.
• You'll have a meeting with the surgical team to talk about the kind of sleep medicine they'll give you and your medical history.
• The surgeon might also ask for blood tests, a chest X-ray, or an electrocardiogram (ECG) to check for other health problems. They'll also look at your family's medical history to avoid issues with sleep medicine.
• If you smoke, it can make getting better after surgery harder. So, try not to smoke for at least a month before your surgery.
• If you're getting the surgery with sleep medicine, don't eat or drink for at least 8 hours before.
• Talk to your doctor about taking your usual medicines with a little water on the morning of the procedure.
• After the surgery, you can do light activities like walking, eating, and going upstairs. You can usually start driving again in about a week and exercising in about four to six weeks. Your doctor will watch how you're doing and decide when you can do your normal routine again.

Possible Complications

Robotic surgeries rarely have post-operative complications. However, some of them may be:

• Incomplete repair or recurrence of the hernia.
• Bleeding that might not stop.
• Chances of infection if adequate sterilisation protocols are not followed.
• Damage to the surrounding tissues/organs.
• Adverse reaction to anaesthesia.

Care After Surgery

Here's what you can expect as you recover at home:

• You should start eating your regular diet slowly. Begin with liquids and then move on to softer and solid foods. This helps prevent problems with sleep medicine.
• Make sure the areas where you were cut stay dry for a few days. Follow what the surgeon says about taking baths and taking care of the bandages. You might need to go back to the surgeon's office in 7 to 10 days to take out the stitches, depending on how the cut is healing.
• Start walking again slowly to get back to your normal activities in a few days.
• Don't lift heavy things for a few weeks – ask your surgeon about it.
• It might take a few weeks to a few months to fully get better.

Review

Reviewed by Dr. Bachan Singh Barthwal, Senior Director, Laparoscopic & Robotic General Surgery.