By Frederick Sabido, M.D., FACS
More than 200,000 Americans are diagnosed with hernia each year. A hernia occurs when an organ or scar tissue pushes through an opening in the muscle or tissue that holds it in place, which produces a bulge. In many cases, a hernia is no more than a painless swelling that presents no problems and doesn’t need immediate medical attention. A hernia may, however, be the cause of discomfort and pain, with symptoms often becoming worse when standing, straining, or lifting heavy items. Most people who notice increasing swelling or soreness eventually see a doctor.
An inguinal hernia is when part of your intestine pushes through a weak spot in your lower belly (abdominal) wall or groin. The hernia creates a lump in your groin. Individuals who are at greater risk for an inguinal hernia include men, obese men and women, pregnant women, those with a family history of inguinal hernia and smokers.
Some activities may increase the risk, for example, chronic coughing or straining to have a bowel movement, and some physicians believe individuals who do a lot of heavy lifting are a greater risk. Immediate medical attention should be sought if an inguinal hernia is painful, causing nausea or vomiting. The swelling, in these cases, is typically firm and tender and cannot be pushed back up into the abdomen.
For an inguinal hernia without symptoms that can be pushed back into the abdomen, the usual course of action is watchful waiting. However, waiting adds the risk of strangulation of the gut, a complication where blood supply is cut off to an area of tissue. This requires emergency surgery to correct.
New studies have shown that patients have a 68 percent chance of needing an operation if they attempt watchful waiting. Careful consideration is needed to determine whether an earlier, routine operation to repair a hernia is warranted rather than an emergency procedure down the road. One of the most common surgical procedures, with thousands performed in the U.S. every year, is hernia repair.
Robotic-assisted inguinal hernia repair surgery is making a strong case for elective repair as the preferred option. This is because robotic surgery has several advantages over traditional surgery, including; smaller incisions, less blood loss during surgery, fewer complications, and shorter recovery periods and hospital stay. In fact, my case volume (I have performed more than 440 robotic-assisted surgeries) and proficiency led the American Hernia Society to invite me to participate in a large-scale collaborative quality study of the procedure, which includes clinical follow-up with my patients for 15 years to monitor outcomes.
The good news is that patients who receive robotic hernia repair surgery avoid the risk of needing emergency surgery. They typically can resume normal activities immediately since they do not need to be given narcotics as part of the procedure or after it’s completed, and do not have post-operative or chronic pain or scarring.
Board certified General Surgeon Frederick Sabido, M.D., FACS, is the Director of the Center for Robotic Surgery at Hackensack Meridian Health Raritan Bay Medical Center-Old Bridge. The experienced surgeon of more than 20 years specializes in Robotic Single Site Cholecystectomy and Robotic Abdominal Wall and Inguinal Hernia repair. Dr. Sabido is Director of Robotic Surgery, Fellowship Program Director and Program Director of the SAGES accredited Robotic Surgery Fellowship at Richmond University Medical Center, An Affiliate of The Mount Sinai Health Network in Staten Island, NY; a certified proctor for Intuitive Surgical, Inc.; and Assistant Clinical Professor of Surgery at SUNY Downstate Medical Center in Brooklyn, NY. The center’s nurse navigator guides patients through their care, for more information call 1-800-DOCTORS.
