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Robots in the Operating Room: Newer technique uses robotics to improve precision in hernia repair
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Robots in the Operating Room: Newer technique uses robotics to improve precision in hernia repair

hernia

SLUCare general surgeon, Dr. Scott Wong, assessing a patient. Photo provided by SLUCare Physician Group

Joe H. had dealt with a hernia for nearly three decades. He first had it repaired back in the ‘90s, and though the recovery was tough, the repair lasted for many years. A second surgery was just as difficult, but the repair didn’t last nearly as long.

“I was hobbling along for a good week or so [after surgery,]” he said. “Until you’re cut in that area, in the lower groin, you don’t realize how much you use those muscles. Getting up out of a chair, getting up out of bed, walking, it’s harder. Recovery is a long, drawn-out process.”

The third time around, Joe says, recovery was much easier. That’s because his surgeon performed the surgery laparoscopically, leaving only three small incisions rather than one large one. And his surgeon, SLUCare's Dr. Scott Wong, used robotic tools to achieve it.

“I’m much happier,” Joe said. “My recovery was just a few days. I feel like I’ll be a lot better off long term.”

Just like a human wrist

Robotically assisted laparoscopic surgery is a newer technique that allows surgeons to see their work more clearly and manipulate surgical instruments in more complex surgeries, all while sitting comfortably at a console in the operating room.

“It allows us better visualization because the picture is magnified in 3D and you can be much more precise in your dissection, which can lead to less blood loss and less tissue damage,” said Dr. Wong, a general surgeon who sees patients at University Tower at 1034 S. Brentwood Boulevard and practices at SSM Health Saint Louis University Hospital and SSM Health St. Mary's Hospital.

“The robotic instruments allow greater degrees of freedom,” he said. “You can rotate standard [laparoscopic] instruments and go up and down, but with robotic instruments, you can move them just like a human wrist. And it’s all done at a console where you can sit down, and it’s more ergonomically advantageous to the surgeon.”

A common surgery

Hernia repair is one of the most common surgeries in the United States, with an estimated one million or more done each year. Today’s surgical techniques are improving outcomes, reducing complications and getting people back to their daily routines more quickly than ever.

A hernia occurs when the muscles that make up the abdominal wall weaken or tear, allowing tissue or organs to bulge through. An inguinal hernia, such as Joe’s, is the most common and occurs in the lower groin.

Surgery is the only way to repair it. Over the years, more surgeons have moved from traditional, or “open” surgery, in which a large incision is used, to minimally invasive laparoscopic surgery, in which the surgeon inserts a thin tube with a miniature video camera — a laparoscope — into a tiny incision in order to see the inside of the body. Repairs are then made through other small incisions, and the patient often goes home the same day.

In Joe’s case, his first two surgeries were open. In his second case, surgical mesh was used as a plug in the weak spot of the muscle, and that mesh plug ended up causing him chronic pain, Dr. Wong said.

“I removed most of the plug that was on the inside of the abdomen and put in flat mesh to close the resulting hole,” he said. “When it lays flat you don’t feel it; it conforms to the anatomy better.”

Robotic tools allow more precision

Robotics are used in many types of surgery. The surgical tools are attached to mechanical “arms,” but they are controlled by the surgeon. For Dr. Wong, this technique has allowed him to perform complex procedures that would have been more difficult with traditional laparoscopic instruments, he said.

“It’s just one of the tools we can use to help improve outcomes and allow patients to get back to their regular activities faster.”

For more information about Dr. Wong and SLUCare General Surgery, visit slucare.edu/general-surgery or call 314-977-4440.

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