Our Summary

This research paper talks about using robotic surgery to repair hiatal hernias, which are a type of hernia that occurs when part of the stomach pushes up into the chest through an opening in the diaphragm. Traditionally, a less intrusive method known as laparoscopic surgery is used for this kind of repair. However, robotic surgery has certain benefits that can overcome the limitations of laparoscopic surgery.

The process of robotic hiatal hernia repair involves several steps, including the reduction of the hernia, dissection of the hernia sac, dissection of the esophagus, closure of the opening in the diaphragm, and a procedure known as fundoplication, which is performed to prevent gastroesophageal reflux.

The results from robotic hiatal hernia repair are comparable to those from the laparoscopic approach, suggesting that robotic surgery is a viable option. The paper also discusses current debates, limitations, and new technologies related to this topic.

FAQs

  1. What are the steps involved in a robotic hiatal hernia repair?
  2. How does a robotic hiatal hernia repair compare to a laparoscopic approach in terms of perioperative outcomes?
  3. What are some of the current controversies and limitations associated with robotic hiatal hernia repair?

Doctor’s Tip

One helpful tip a doctor might give a patient about hernia repair is to follow post-operative instructions carefully, including restrictions on lifting heavy objects and avoiding strenuous activities for a certain period of time. It is important to allow the surgical site to heal properly in order to prevent complications and ensure a successful recovery. Additionally, maintaining a healthy diet and exercising regularly can help prevent future hernias from developing.

Suitable For

Patients who are typically recommended for hernia repair include those with symptomatic hiatal hernias, paraesophageal hernias, or hernias that are causing complications such as gastroesophageal reflux disease (GERD), difficulty swallowing, chest pain, or respiratory issues. Patients who have failed conservative management strategies such as lifestyle modifications, medications, and endoscopic therapies may also be candidates for hernia repair. Additionally, patients who are at risk for complications such as strangulation or obstruction of the hernia contents may require surgical intervention. Overall, the decision to undergo hernia repair should be individualized based on the patient’s specific symptoms, medical history, and overall health status.

Timeline

Before hernia repair:

  1. Patient may experience symptoms such as heartburn, chest pain, difficulty swallowing, regurgitation, and abdominal pain.
  2. Patient undergoes diagnostic tests such as endoscopy, barium swallow, and imaging studies to confirm the presence of a hiatal hernia.
  3. Patient may be advised to make lifestyle changes such as weight loss, dietary modifications, and avoiding trigger foods.

After hernia repair:

  1. Patient undergoes preoperative assessment and clearance for surgery.
  2. Surgery is performed using a minimally invasive robotic approach, which includes reduction of hernia contents, dissection of hernia sac, crural closure, and fundoplication.
  3. Patient is monitored in the recovery room and may stay in the hospital for a day or two postoperatively.
  4. Patient is discharged home with instructions for postoperative care, including pain management, diet modifications, and activity restrictions.
  5. Patient follows up with their surgeon for postoperative visits to monitor recovery and address any concerns.

What to Ask Your Doctor

  1. What type of hernia do I have and what are the treatment options available?
  2. Why do you recommend a robotic approach for my hernia repair?
  3. What are the potential risks and complications associated with robotic hernia repair?
  4. How long is the recovery process after robotic hernia repair?
  5. Will I need to follow any specific dietary or activity restrictions after the surgery?
  6. What is the success rate of robotic hernia repair compared to other surgical methods?
  7. How many robotic hernia repairs have you performed and what is your experience with this technique?
  8. Will I need any additional follow-up appointments after the surgery?
  9. How soon can I expect to see improvement in my symptoms after the hernia repair?
  10. Are there any alternative treatments or therapies that I should consider before undergoing robotic hernia repair?

Reference

Authors: McClinton A, Zarnegar R, Dakin G, Afaneh C. Journal: Surg Clin North Am. 2025 Feb;105(1):125-142. doi: 10.1016/j.suc.2024.06.010. Epub 2024 Sep 6. PMID: 39523068