Robotic Hernia Repair

Video Transcript

What Is A Hernia?

A hernia is two things. It's a hole in the muscle layer of our abdominal wall. Our muscle layer is what holds us together. Everything else kind of has stretch to it. The muscle layer develops a hole then that's the first part of a hernia. The second part is the layer just inside that hole starts to bubble through. The same way you kind of blow a bubble with bubble gum that is exactly what a hernia is. How to imagine it.

What Is The da Vinci Robotic Surgical System?

What the da Vinci robot, we call it "the robot", does is take our hands off of the instruments and the camera and attaches them to this robotic machine. And then the surgeon uses a console that sits in the room. And we put our hands into it and we use our hands on these controllers and we look into this console that gives us the view of the camera. And our hands manipulate the robot and move the camera. So it's essentially a tool that's allowed us to become more precise and have better visualization of minimally invasive surgery.

How Is A Hernia Repaired? What Are The Advantages of Robotic Surgery?

The problems are fixed because in an open hernia surgery you find the little hole in the muscle layer and you essentially repair it using a piece of a prosthetic mesh because you're patching the hole. You can't just sew the hole closed because you're just creating tension again, right? And tension is what caused the hernia in the first place. So if you just sew it up, you kind of putting it together then opens back up. So I often hear people say, "Are you going to use mesh?" and the answer to that question pretty much nowadays, all the time, is "Yes we are going to use mesh" because it allows you to perform what's called a tension free repair. So an open hernia surgery you find the little hole, you patch it, you sew in the mesh around the hole and it works great. But the piece of mesh is relatively small and it's on the outside of the defect. Still a great way to fix hernias. Tried and true for decades.

But now with "the robot" or laparoscopic surgery you're able to go in from behind where the hole is. And how does a tire get patched, right? You got a hole in the tire you put the patch on the inside because the pressure from the tire holds the patch up there, right? So that's really a great place to put the piece of mesh is on the inside because the pressure from inside your abdomen is going to hold that patch there. But the problems with laparoscopic surgery are that you're, even though you can see better and you get the mesh right where you're at, the instrumentation isn't as good to actually sew or fix that mesh in very well. With the da Vinci or "the robot" manipulating the instruments allow you to use the wrists. That's really the breakthrough of da Vinci surgery is that the instruments instead of just going like this go in and out. They actually have wristed motion so it’s better to sew. So I'm more confident that I can sew the mesh in and get you a better repair.

What Should A Patient Know Before Hernia Surgery?

Surgery is not a haircut. You're going to be in the hospital. There's going to be some discomfort. But, I think it's most important for a patient that's having surgery, any kid of surgery, to know is that the physician or the surgeon that they choose and the method that they use that the surgeon is comfortable with that method, feels that it is the best method for that patient, and no matter what that surgeon is there for the patient throughout the entire experience. It's critical for the patient to understand that the surgeon and the patient are in it together. And that if it goes well for the patient it goes well for the surgeon.

Is The da Vinci Robot Safe?

There is nothing that is used as a tool in the operating room that is unsafe because it never would have made it to the operating room if there was any evidence to suggest that it was unsafe. Is the tool that the surgeon is using a safe method for that surgeon to be using is a more important question, and that's something addressed with each surgeon and a patient.

Would You Recommend Brookings Health System?

I would recommend Brookings Health System as a place to have any kind of medical care because it's... people who want to come to Brookings Health System live in Brookings, and I would just tell them that there is absolutely no reason for you to go anywhere else. This hospital has top notch facilities. The nursing care is fantastic. The physicians are talented and well educated and well trained. There's really no reason to go anywhere else.