What are the Latest Advances in Robotic Hernia Repair?

While there’s not a lot new with the technology itself, what’s new at Cleveland Clinic is that we’re now offering robotic hernia repair to more and more patients.

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We not only offer it to those who have small ventral hernias, but also in some cases to those who need abdominal wall reconstruction ― which is currently only being done at a handful of U.S. centers.

Who qualifies?

Not everyone is a candidate for a robotic approach, but the ones who are may benefit from less time in the hospital, a quicker recovery and less pain.

According to a study published in the Annals of Surgery, of which I am a co-author, patients with abdominal wall reconstructions go home an average of at least one full day sooner than if they got an open abdominal wall reconstruction.

Good candidates include those who have central defects, usually 8 to 15 cm in diameter and who are generally candidates for a minimally invasive procedure. Contraindications to robotic hernia repair may include those requiring emergent repair and those needing skin resected from a skin graft or substantial scar.

Commitment, continued research

In our Hernia Center, we are committed to offering these robotic hernia procedures to patients who want them.

It’s always a mixed bag when I offer a robotic approach to patients. Some of them are like, “I don’t want that crazy robotic stuff!” And some of them say, “Wait, I get a smaller incision? Sure, I want to try it!”

I began performing robotic hernia repairs four years ago and am continually increasing my volume of cases on the robot.

We’re dedicated to furthering research in the area and following our outcomes. My partners and I are currently enrolling patients in two randomized controlled trials, looking at outcomes in laparoscopic versus robotic inguinal hernia repairs and laparoscopic versus robotic ventral hernia repairs.

And we’re always looking at outcomes. Every case that we do goes into our Americas Hernia Society Quality Collaborative database so we can continually optimize both outcomes and optimize costs.