Have a Hernia? Learn About the Latest Advances in Hernia Repair

Hernia repair has come a long way from traditional open surgery. Thanks to rapid advancements in medical technology and surgical techniques, today’s hernia treatments are safer, less invasive and more effective than ever before. From robotic-assisted procedures to innovative mesh materials designed to reduce complications and improve healing, the landscape of hernia repair is evolving quickly.

Here, Dr. Amanda Berlekamp, a general surgeon at Southwest General Health Center, discusses the latest breakthroughs in hernia care, which are transforming patient outcomes.

What Is a Hernia, Exactly?

A hernia is a weakness in the abdominal wall that allows internal organs to push outward, forming a visible lump or bulge. They most commonly appear around the belly button, groin or previous surgical sites. Patients typically seek medical attention when the hernia causes pain or discomfort.

“In the worst-case scenarios, when the bowel or other organs start to push through, it causes emergencies where patients come in with nausea, vomiting, or they can't pass gas or have a bowel movement. Then, we do have to proceed with emergency surgery to repair those,” states Dr. Berlekamp. “Of course, we like to fix them before it gets to that point.”

Open Surgery, Laparoscopic or Robotic Hernia Repair: Which One?

The choice between open, laparoscopic or robotic surgery for hernia repair depends on various individual factors, including the patient’s medical history, previous surgeries and the location and complexity of the hernia. While minimally invasive methods, especially robotic surgery, are generally preferred, laparoscopic surgery may still be appropriate in some cases. Open surgery is rarely used but may be necessary for emergencies or particularly complex hernias.

Robotic surgery enhances traditional laparoscopic techniques by offering greater precision and control. Unlike standard laparoscopy, which uses two instruments and a 2D camera, robotic surgery allows the surgeon to control four robotic arms from a nearby console. This setup provides 3D vision and improved maneuverability, giving the surgeon complete control over the camera and instruments for more advanced and refined procedures.

“Those instruments are wristed. It's like using our hands inside the patient's abdomen, which makes surgery more accurate, precise and delicate so that patients have a better recovery, safer surgery and get back to their normal activities quicker,” notes Dr. Berlekamp.

Minimally invasive hernia repair typically involves three small incisions, about the width of a fingernail, placed on the upper belly or left side of the abdomen. These small cuts cause less muscle damage than traditional open surgery, resulting in less post-operative pain and a quicker return to daily activities.

Are There Risks to Hernia Repair Surgery?

The most common risks with hernia surgery are bleeding and infection, though these are rare. Specific to hernia repair, there is a small risk of injuring the bowel or nearby blood vessels and a low risk of mesh infection, as the mesh is a foreign material placed in the body. Despite careful repair, there is also a small chance that the hernia could recur, although recurrence rates remain in the low single digits.

While there is concern surrounding the mesh repair, due to media coverage, Dr. Berlekamp assures it is safe and a truly effective way to repair the hernia. “Without using mesh, the chance of the hernia coming back is twice as high. Really, most, if not all, the repairs we're doing now are using meshes unless there are specific cases of emergency surgery with contaminated fields,” she explains. “That gets into some of the nitty-gritty of hernia repairs.”