A hernia is a weak point in the barrier between our organs and our skin. Usually in the abdominal wall or groin, a hernia allows an organ to stick out. A person with a hernia can usually feel it as a bulge, especially when they cough, stand up, or strain.
Like a cavity in your teeth, a hernia is easy to ignore when it’s small. But, just as a cavity can eventually wreck the inside of a tooth, a hernia can grow larger until it’s a major problem.
Hernias don’t heal by themselves, but surgery to repair them is common.
“If you notice a hernia you should get it fixed and if a hernia causes you discomfort you should definitely get it fixed,” says Creighton Fiscina, MD, a general surgeon at AdventHealth Altamonte Springs, formerly Florida Hospital Altamonte.
At one time, hernias were repaired using an “open” surgical method. This means the surgeon makes a cut large enough to be able to see all of the organs involved.
This is like opening up an entire roof to fix a small leak, Dr. Fiscina says. Using a smaller hole to go inside the roof would be the better approach, he said.
That’s the idea behind minimally invasive surgery. A surgeon can make small cuts and perform the procedure with narrow tools equipped with a tiny camera. But these tools usually can’t turn the way a human wrist can.
That’s where the robot comes in. Whether Dr. Fiscina needs finesse to make a cut just right or power to close the hernia, the robot can provide it. The robot’s arms can turn like a wrist can, and its camera allows him to see his patients in more detail.
“They’ve fine-tuned the optics on their scopes,” he said. That allows him to see more clearly what to avoid and where to operate.
The benefits to a patient of robotic surgery over open surgery include less pain, faster recovery and smaller scars. The benefits of using a robot over other forms of minimally invasive surgery — where surgeons make smaller cuts but still use hand-held tools — are less clear. But Dr. Fiscina believes time will show robotic surgery to be superior.
“As the wave of the future, the vast majority of surgery will be done robotically,” he says.
How Robotic Surgery Works
For many people, the idea of robotic surgery conjures up an image of a machine performing surgery by itself. But that’s not how it works.
“The robot does nothing by itself,” Dr. Fiscina says. “All the movements are done by me on the console in the room with the patient.”
The surgeon sits down at the console and controls the robot using handles and foot pedals while looking into a high-definition screen. It’s basically an extension of the surgeon that allows them more power, control and vision.
“Truly, we’re at a point right now in medicine where the sky’s the limit with robotic surgery,” Dr. Fiscina says.
Benefits of Robotic Surgery
During his postgraduate training, Dr. Fiscina performed a variety of surgeries using open and minimally invasive methods. After starting at AdventHealth, he learned how to perform robotic surgery.
When it comes to hernia repair, he’s found robotic techniques have been particularly helpful to help patients with multiple hernias or particularly complicated ones.
Meanwhile, patients have been returning to work more quickly. No longer is a week of recovery needed after an operation.
“It depends on the particular case, but for a typical surgery on Thursday you can be back to work on Monday,” he said.
It also matters how the hernia’s hole is closed and how the mesh is attached to the patient. Dr. Fiscina says some surgeons use tacks, but he says they can be more painful for patients. He prefers to sew the hernia closed and sew the mesh patch to reinforce it.
The goal is to have the mesh lie flat, not bow out. That helps the hernia repair stay closed.
Get Your Hernia Fixed
Though it’s easy to ignore a small hernia, it will only become more painful as it grows, Dr. Fiscina says. Moreover, untreated hernias can lead to dangerous complications.
The part of an organ that’s poking through the hernia can get trapped outside the abdominal wall, or “incarcerated.” Worse, it can get cut off from its blood supply, or “strangulated,” and require emergency surgery to fix.
“Anyone who has a hernia should get it repaired,” Dr. Fiscina says.
AdventHealth offers the latest surgical techniques to repair hernias and perform other types of surgeries. In March, AdventHealth Altamonte Springs became the first hospital in the state to use a new robotic device during minimally invasive spine surgery.
And, in May, AdventHealth for Women doctors became the first in Florida to use a new robotic surgical system to perform minimally invasive gynecological procedures.
Getting your hernia repaired is an important step in taking control over your health and feeling whole. If you’d like to learn more about your options at AdventHealth Altamonte Springs, please visit our website or call Call407-543-4670.