HOW IS THE PROCEDURE PERFORMED?

There are few options available for a patient with a ventral hernia.

• The use of an abdominal wall binder is occasionally prescribed but often ineffective.
• Ventral hernias do not go away on their own and may enlarge with time.
• Surgery is the preferred treatment and is done in one of two ways.

1. The traditional approach is done through an incision in the abdominal wall. It may go through part or all of a previous incision, skin, an underlying fatty layer and into the abdomen. The surgeon may choose to sew your natural tissue back together, but frequently, it requires the placement of mesh (screen) in or on the abdominal wall for a sound closure. This technique is most often performed under a general anesthetic but in certain situations may be done under local anesthesia with sedation or spinal anesthesia. Our surgeons will help you select the anesthesia that is best for you.
2. The second approach is a robotic ventral hernia repair. In this approach, a laparoscope (a tiny telescope with a television camera attached) is inserted through a cannula (a small hollow tube).

The laparoscope and TV camera allows our team to view the hernia from the inside. Other small incisions will be required for other small cannulas for placement of other instruments to remove any scar tissue and to insert a surgical mesh into the abdomen. This mesh, or screen, is fixed under the hernia defect to the strong tissues of the abdominal wall. It is held in place with special surgical tacks and in many instances, sutures. Usually, three or four 1/4 inch to 1/2 inch incisions are necessary. The sutures, which go through the entire thickness of the abdominal wall, are placed through smaller incisions around the circumference of the mesh. This operation is usually performed under general anesthesia.

WHAT SHOULD I EXPECT THE DAY OF SURGERY?

• 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.

WHAT HAPPENS IF THE OPERATION CANNOT BE PERFORMED OR COMPLETED BY THE ROBOTIC METHOD?

In a small number of patients the laparoscopic 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 One Surgical either before or during the actual operation. When our team 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.

WHAT SHOULD I EXPECT AFTER SURGERY?

• Patients are encouraged to engage in light activity while at home after surgery. One Surgical will determine the extent of activity, including lifting and other forms of physical exertion. Follow our 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 our surgeons immediately.
• If you have prolonged soreness and are getting no relief from your prescribed pain medication, you should notify our surgeons.
• Most patients are able to get back to their normal activities in a short period of time. These activities include showering, driving, walking up stairs, lifting, work and sexual intercourse.
• 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, our surgeons 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.

WHAT COMPLICATIONS CAN OCCUR?

• 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. Our surgeons 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 robotic or traditional, you should ask our surgeons about his/her training and experience.

WHEN TO CALL

Be sure to call our surgeons 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

Have Questions? Call (201) 343-3433 or request an appointment online.