Robotic surgery transforming hernia and reflux treatment
Minimally invasive robotic-assisted surgery has been used for years to treat prostate cancer and many gynecologic conditions. But it’s now more commonly being used to treat a variety of other conditions at Adena Health System, including:
Your gallbladder stores bile, which is released to your liver and small intestine during digestion through a tube called the common bile duct. Bile helps digest the fat you eat, but if something blocks its way, you can experience a gallstone attack signaled by vomiting, nausea, and pain in the abdomen, back, or under your right arm.
Treatment: Since you can live without your gallbladder, removing it—a procedure called cholecystectomy—is the best way to avoid a recurring problem. At Adena, our surgeons can perform this common surgery through a single incision in the belly button with the help of the da Vinci Si Surgical System. With virtually no scarring, minimal pain, and a faster recovery, this minimally invasive procedure is a good option for gallbladder removal.
Common in people over age 50, hiatal hernia is a condition where a part of your stomach pushes through the opening of your diaphragm and up into your chest. It can cause pain, heartburn, and swallowing difficulty. The exact cause of this type of hernia is unknown, but aging, weight, and smoking can all raise your risk.
Treatment: Your physician will often recommend lifestyle changes first to help minimize symptoms. Avoiding large meals along with losing weight and staying upright after eating can help reduce the discomfort of acid reflux. If these tactics don’t help, a procedure called Nissen fundoplication might be necessary. During the surgery, which can be done through just a few small incisions with the da Vinci Si Surgical System, the fundus, or upper curve of the stomach, is wrapped around the area where the esophagus and stomach meet. Once sewn into place, the hiatal opening is reduced and a barrier is created to reduce reflux.
If you’ve had abdominal surgery, a sac formed by the lining of the abdominal cavity can poke through an incompletely healed incision creating an incisional hernia. While it can happen with any surgical incision, this type of hernia is most common with vernal incisions that run from the sternum to the pubis. The herniated area causes a bulge at the site of the incision that can lead to pain and infection.
Treatment: Repair of an incisional hernia typically involves a procedure where surgeons attach synthetic mesh to your abdominal wall beneath the abdominal muscles. With a da Vinci-assisted procedure, the surgeon uses the robotic instruments, inserted through very small incisions, to suture the mesh in place. Because it’s minimally invasive, the surgery leads to faster healing, fewer complications, and less postoperative pain.
GERD (Gastroesophageal reflux disease)
For people with gastroesophageal reflux disease (GERD), eating and even sleeping can cause severe discomfort. More than 15 million Americans experience heartburn each day. Often it’s the result of GERD, where acid from the stomach flows backward and irritates the esophagus, causing a burning feeling behind the sternum and into the neck and throat. Exacerbated by obesity, certain types and quantities of foods, and by lying flat, GERD can lead to swallowing or choking problems, pain that mimics a heart attack, and even cancer of the esophagus. Your physician may conduct an upper GI (gastrointestinal) test using liquid barium and X-ray or an endoscopy, which uses a small, lighted tube and camera to look down your esophagus.
Treatment: Over-the-counter and prescription medications, such as antacids and proton pump inhibitors, are your first line of defense, along with diet and lifestyle modifications, such as raising the head of your bed. For more serious cases that don’t respond to medication, your physician may recommend Nissen fundoplication. The open version of this surgery requires an 8-inch incision in the abdomen, but surgeons performing fundoplication with the da Vinci Si Surgical System require just 1 to 2 cm incisions. Manipulating surgical instruments robotically, the surgeon creates a barrier between the esophagus and stomach to prevent the flow of acid in the wrong direction by wrapping the fundus, or upper curve of the stomach, around the junction of the two. This procedure also is effective in treating hiatal hernia.
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