Intuitive Surgical recently released results of a study that demonstrated the effectiveness of their da Vinci Surgical System in ventral hernia procedures. While laparoscopic and robotic-assisted surgeries are becoming more and more commonplace, hernia repairs have remained something of an outlier. The American College of Surgeon’s National Surgical Quality Improvement Program database suggests that nearly three-quarters of such procedures are still performed as open surgery.
The study found that patients who underwent robotic-assisted ventral or incisional hernia procedures had comparable or improved results in several key areas, such as intra-operative complications and surgical site infections. Patients also experienced the usual benefits of the minimally invasive approach. Approximately sixty percent of patients in the study were discharged on the same day as the procedure.
To learn more, Surgical Products conducted an email interview with the lead author of the study, Anthony M. Gonzalez, M.D., chief of surgery at Baptist Hospital, located in Miami, and general surgeon at Baptist Health’s Center for Robotic Surgery.
Though robotic-assisted and laparoscopic surgery are becoming increasingly common, the vast majority of hernia repair procedures are done via open surgery. Why do you think there’s been a slower adaptation to new technologies in this area?
There are several reasons for this. These procedures require an advanced skill set to complete, so those trained in minimally invasive surgery are more likely to perform it. Secondly, not all ventral hernias are best treated via laparoscopy or robotic-assisted surgery. Those very small or large are best done via open surgery. Lastly, there may be limited resources in some hospitals, namely robotic-assisted technology.
What are the chief benefits that a robotic-assisted approach brings to this procedure, particularly those benefits that might be fairly unique to hernia repair?
Robotic-assisted surgery allows for closure of the hernia defect, which I have recently noticed is necessary for improved outcomes after ventral hernia repair. This was not possible laparoscopically. Secondly, mesh fixation can be done with sutures using a robotic-assisted surgical approach, which will help decrease both pain and cost as compared to surgical approaches used in laparoscopic hernia repair.
How does opting for robotic-assisted surgery in hernia repair impact patient recovery?
As mentioned above, if there is less pain, patients recover faster. In addition, the robotic-assisted approach allows more patients access to minimally invasive surgery, which has been shown to enhance recovery and reduce complications when compared to open surgery in many disciplines.