Hernia Surgery Options

---

The general scientific knowledge of hernias has grown exponentially in the last few years. Advancements in technology have also greatly increased our surgery options. The surgeons at The PATCH Institute are experts in utilizing the latest knowledge, techniques and technology to repair your hernia with the smallest scars, quickest recovery and lowest complication rate. During the consultation, your surgeon will determine the best surgery option for you.

This is the traditional approach with a larger incision at the hernia bulge. This type of surgery is still preferred when the hernia is either very small or very complex. For example, many inguinal and umbilical hernias are many times best performed open. Open surgery is sometimes better in complex hernia repairs when there is mesh to be removed, when intestine needs to be resected or when there is a lot of skin/fat that needs to be removed.

A form of minimally invasive surgery introduced in the 1980’s. Laparoscopic surgery uses small incisions away from the hernia bulge.  It frequently leads to less complications than open surgery. Today, it is used for hernia repairs that don’t require advanced robotic surgical systems.  It has several limitations:  the surgeon uses straight instruments that may limit the precision of surgery, it is difficult to place mesh outside the abdominal cavity, more surgeon fatigue due to poor ergonomics, and it requires sometimes painful fixation tacks and sutures.

A form of minimally invasive surgery through small incisions. It utilizes advanced robotic surgical systems such as the daVinci robot. The robot is not autonomous. It is simply a more advanced surgical tool and is FULLY controlled by the surgeon. The robotic platform offers the surgeon fully wristed instruments and a 3D high-definition camera with 10x magnification. As a result, the repair can be done with more precision, and complex hernias can be fixed with small incisions. Furthermore, the robot doesn’t get tired and the surgeon sits during surgery, so there is less surgeon fatigue. For the patient, this translates into quicker recovery, less pain and less complications. This is the preferred approach for medium to large hernias and many inguinal hernias as it combines the best of open and laparoscopic surgeries. Also, the surgeon is more likely to be able to sandwich the mesh between layers of the abdominal wall to keep the mesh from coming into contact with the intestines.

Sometimes the best option is to combine multiple techniques. We call this a hybrid technique because we may perform part of the operation robotically and another part open.  Hybrid surgery is frequently performed for complex or unusual hernias, and ones that require skin or soft tissue removal.  

Regardless of the option that is right for you, the surgeon's experience is probably what matters most.  Using the latest robotic technology does not guarantee great results.  Frequently surgeons will promise a laparoscopic or robotic approach but have a high conversion rate to open surgery.  At The PATCH Institute we are experts at minimally invasive hernia repair, and have an extremely low conversion rate.