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Robotic Hernia Repair

Zhamak Khorgami, Wei T Li, Theresa N Jackson, C Anthony Howard, Guido M Sclabas
BACKGROUND: Robotic-assisted surgery (RAS) with its advantages continues to gain popularity among surgeons. This study analyzed the increased costs of RAS in common surgical procedures using the National Inpatient Sample. METHODS: Retrospective analysis of the 2012-2014 Healthcare Cost and Utilization Project-NIS was performed for the following laparoscopic/robotic procedures: cholecystectomy, ventral hernia repair, right and left hemicolectomy, sigmoidectomy, abdominoperineal resection, and total abdominal hysterectomy (TAH)...
October 16, 2018: Surgical Endoscopy
Joey A Jarrard, Michael R Arroyo, B Todd Moore
BACKGROUND: The true incidence of occult contralateral inguinal hernia is unknown; however, when found, there exists controversy as to whether or not they should be repaired. The aim of our study is to identify the incidence of contralateral incidental inguinal hernias in our surgical population, compare our results to previous studies timelining occult hernia identification to repair need, and generate debate as to whether incidental contralateral hernias should be repaired at the index operation...
October 16, 2018: Surgical Endoscopy
Victor Maciel, Wilmer Mata, Gabriel Arevalo, Marianna Zeichen, Timothy Glass
OBJECTIVE: To present our technique of robotic retrorectus parastomal hernia repair. BACKGROUND: Parastomal hernias represent a significant problem with high recurrence and long-term complications. An estimated of 120,000 new stomas are created per year with a prevalence of up to 800,000 patients in the U.S. 40-60% of these ostomies will never be reversed. Parastomal hernias cause skin breakdown and make adherence of ostomy appliances difficult, creating the need for frequent bag exchanges...
September 24, 2018: Journal of Robotic Surgery
F Muysoms, S Van Cleven, P Pletinckx, C Ballecer, A Ramaswamy
PURPOSE: The use of extraperitoneal mesh in place of intra-peritoneal mesh is gaining popularity in laparoscopic ventral hernia repair. We have adopted a robotic assisted laparoscopic technique using a lateral single-dock robotic access with retromuscular mesh placement after opening the ipsilateral posterior rectus fascia. In this study, we wanted to evaluate the changes in operative times during the initial experience with this novel technique. METHODS: The initial consecutive patients undergoing robotic assisted transabdominal retromuscular umbilical prosthetic repair (r-TARUP) using a 15 × 15 cm self-fixating mesh were prospectively entered in the study and the operative times during the separate steps of the surgical procedure were recorded...
September 22, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Sarah Mustafa, Elizabeth Handren, Drew Farmer, Estrellita Ontiveros, Gerald O Ogola, Steven G Leeds
OBJECTIVE: Resident education is evolving as more cases move from open to minimally invasive. Many programs struggle to incorporate minimally invasive surgery education due to increased operative time and higher cost when residents participate. The aim of this paper is to examine if the implementation of a robotics curriculum enhances minimally invasive surgical training. DESIGN: A retrospective review of all ventral and inguinal hernia cases performed from March 2013 to November 2017 was conducted to determine operative technique utilized (open, laparoscopic, or robotic) and resident involvement...
September 12, 2018: Journal of Surgical Education
Dario Amore, Carlo Bergaminelli, Davide Di Natale, Dino Casazza, Roberto Scaramuzzi, Carlo Curcio
Morgagni hernia is a relatively uncommon congenital diaphragmatic hernia in which abdominal contents protrude into the chest through the foramen of Morgagni. It usually occurs on the right side of the chest but may occur on the left side or in the midline. In adults, it commonly presents with non-specific symptoms such as dyspnea, cough, gastroesophageal reflux disease and other. Surgical repair should be always performed to prevent the risk of hernia incarceration. Transthoracic approach has been proposed especially in cases with indeterminate, anterior pericardial masses...
July 2018: Journal of Thoracic Disease
Ty Kirkpatrick, Bethany Zimmerman, Karl LeBlanc
BACKGROUND: Robotic-assisted surgery has proved to be a valuable modality in specialties such as urology and gynecology and has gained wide acceptance in those fields. Its value in general surgery, however, has had a slower acceptance rate among surgeons. This study reviews my first 150 cases using the robot for one of the most common general surgery operations-the repair of hernias. MATERIALS AND METHODS: All robotic hernia cases performed by a single surgeon were documented in an Excel� (Microsoft Corporation, Redmond, Washington) spreadsheet beginning in April, 2014...
August 14, 2018: Surgical Technology International
Ramon Diez-Barroso, Carlos H Palacio, Julian A Martinez, Konstantinos Makris, Nader N Massarweh, Christy Y Chai, Samir S Awad, Hop S Tran Cao
BACKGROUND: With the increasing use of the robotic platform in general surgery, whether 8-mm ports should be closed comes into question. We sought to characterize the incidence of port-site hernias (PSHs) among patients undergoing robotic-assisted general surgery. METHODS: A retrospective chart review of a single institutional database identified patients who underwent robotic-assisted general surgery from July 2010 to December 2016. For each patient, the number, type, location, and size of all ports were collected...
October 2018: Journal of Surgical Research
Vernissia Tam, Jeffrey Borrebach, Stefanie Altieri Dunn, Johanna Bellon, Herbert J Zeh, Melissa E Hogg
BACKGROUND: While proficiency-based robotic training has been shown to enhance skill acquisition, no studies have shown that training leads to improved outcomes or quality measures. METHODS: Board-certified general surgeons participated in an optional proficiency-based robotic training curriculum and outcomes from robotic hernia cases were analyzed. Multivariable analysis was performed for operative times to adjust for patient and surgical variables. RESULTS: Six out of 16 (38%) surgeons completed training and 210 robotic hernia cases were analyzed...
August 3, 2018: American Journal of Surgery
P L Tenzel, Z F Williams, R A McCarthy, W W Hope
PURPOSE: Given the difficulty of durable repairs, there is continued interest in hernia prevention. One emerging prevention technique for parastomal hernias is prophylactic mesh placement, whereby mesh is inserted during the index procedure as hernia prophylaxis. We evaluated our experience using prophylactic mesh when creating an ileal conduit. METHODS: We retrospectively reviewed patients undergoing robotic cystectomy with ileal conduit from 6/2010 to 8/2017. Patient demographics and operative/perioperative outcomes were documented...
October 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Yonggang Huang, Ping Wang
Direct suture repair with mesh reinforcement is the main surgical procedure in ventral hernia repair. The best place for mesh implantation is retromuscular space which means sublay. The most commonly used techniques are open sublay and laparoscopic IPOM repair. But open sublay repair may cause more trauma to the abdominal wall and result in more infections. Laparoscopic IPOM repair carries an increased risk in bowel injury, mesh-related complications and postoperative pain. Germany surgeon Reinpold developed a new technique defined as "MILOS concept" by combining the advantages of open sublay and laparoscopic IPOM repair...
July 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Wen Tian, Yang Fei
Da Vinci robotic surgical system has brought giant evolution to minimally invasive surgery, and also improved the development of hernia surgery. Recently, Da Vinci robotic surgical system has been successfully applied to the repair of incisional hernia, inguinal hernia, and esophageal hiatal hernia. In the area of incisional herniorrhaphy, endowrist with 7 degrees of freedom, high definition and naked eye 3D imaging system can make Da Vinci robotic surgical system easy to complete the subtle suture in the anterior abdominal wall from the abdominal cavity...
July 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Ali Fuat Atmaca, Nurullah Hamidi, Abdullah Erdem Canda, Murat Keske, Arslan Ardicoglu
PURPOSE: To assessment the safety of concurrent repair of inguinal hernia (IH) with mesh application during transperitoneal robotic-assisted radical prostatectomy(RARP). MATERIALS AND METHODS: Data of 20 patients (totally 25 procedures) who performed concurrent IH repair with mesh application during RARP were retrospectively enrolled in this study. Preoperative patient characteristics, intra and postoperative parameters (pathological Gleason grade, prostate volume at surgical specimen, operative time, herniorrhaphy time, estimated blood loss, complications, time of hospitalization, catheterization, and drainage) were evaluated...
July 23, 2018: Urology Journal
Maria S Altieri, Jie Yang, Jianjin Xu, Mark Talamini, Aurora Pryor, Dana A Telem
The purpose of our study is to assess outcomes following robotic ventral hernia (RVH) repair. The New York Statewide Planning and Research Cooperative System administrative database was used to identify all patients undergoing laparoscopic ventral hernia (LVH) and RVH between 2010 and 2013. Outcome measures including complications, hospital length of stay (HLOS), 30-day readmissions, and 30-day emergency department (ED) visits were compared. Propensity score (PS) analysis was used to estimate the adjusted marginal differences between patients who underwent robotic-assisted and laparoscopic procedures...
June 1, 2018: American Surgeon
I Belyansky, H Reza Zahiri, Z Sanford, A S Weltz, A Park
BACKGROUND: The enhanced-view totally extraperitoneal (eTEP) hernia repair technique was first described for laparoscopic inguinal hernia repair and later applied to laparoscopic ventral and incisional hernia repair. We present our center's early operative outcomes utilizing principles of this technique during robotic ventral and incisional hernia repair for implementation of the robotic eTEP Rives-Stoppa (eRS) and eTEP transversus abdominis release (eTAR) techniques. METHODS: A review of a prospectively maintained database of hernia patients was conducted identifying 37 patients who underwent robotic eTEP for ventral, incisional, flank or parastomal hernia repair between March and October 2017...
October 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Raelina S Howell, Melissa Fazzari, Patrizio Petrone, Alexander Barkan, Keneth Hall, María José Servide, María Fernanda Anduaga, Collin E M Brathwaite
Background and Objectives: Paraesophageal hiatal hernia repair can be performed with or without mesh reinforcement. The use, technique, and mesh type remain controversial because of mixed reports on mesh-related complications. Short-term outcomes have become important in all forms of surgery. Methods: From January 2012 through April 2017, all patients who underwent isolated hiatal hernia repair in our center were reviewed. Concomitant bariatric surgery cases were excluded...
April 2018: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Akira Miyajima
With an increase in their prevalence, it has become apparent that both benign prostatic hyperplasia and radical prostatectomy for cancer can induce inguinal hernia development. An inguinal hernia is a common late complication following radical prostatectomy, with an occurrence rate of 12-25%. Following radical prostatectomy, the space of Retzius can develop adhesions to surrounding tissue, often causing difficulty during inguinal hernia repair. Conversely, inguinal hernia repair before radical prostatectomy also induces severe adhesions around the space of Retzius and causes difficulty during radical prostatectomy...
July 2018: International Journal of Urology: Official Journal of the Japanese Urological Association
James G Bittner Iv, Lawrence W Cesnik, Thomas Kirwan, Laurie Wolf, Dongjing Guo
Unfortunately, the online published article has errors in Table 2. The number "118.0" found under the column "L-IHR" and row "Time from IHR to resume activities" should be corrected to 18.0.
June 18, 2018: Journal of Robotic Surgery
Mario Lima, Niel Di Salvo, Sara Ugolini, Michele Libri, Giovanni Ruggeri
Bochdalek hernia (BH) is a major malformation that consists of a postero-lateral diaphragmatic defect through which abdominal contents can migrate into the thorax. It is most commonly a neonatal pathology associated with significant morbidity and mortality. Rarely, this type of congenital diaphragmatic hernia (CDH) presents later in life, some even in adulthood. Indications for surgery are not clear even though the majority of authors, being aware of the possible severe complications, recommend surgical correction in all cases...
May 25, 2018: La Pediatria Medica e Chirurgica: Medical and Surgical Pediatrics
Filip Muysoms, Stijn Van Cleven, Iris Kyle-Leinhase, Conrad Ballecer, Archana Ramaswamy
BACKGROUND: Robotic groin hernia repair (r-TAPP) is demonstrating rapid adoption in the US. Barriers in Europe include: low availability of robotic systems to general surgeons, cost of robotic instruments, and the perception of longer operative time. METHODS: Patients undergoing r-TAPP in our start-up period were prospectively entered in the EuraHS database and compared to laparoscopic TAPP (l-TAPP) performed by the same surgeon within the context of two other prospective studies...
May 15, 2018: Surgical Endoscopy
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