INCISIONAL HERNIA AND ROBOTIC INCISIONAL HERNIA REPAIR
An incisional hernia is a type of abdominal wall hernia that develops at the site of a previous surgical incision due to weakness or incomplete healing of the abdominal muscles and fascia. It may occur months or even years after abdominal surgery and is associated with risk factors such as wound infection, obesity, diabetes, smoking, advanced age, chronic cough, heavy lifting, and increased intra-abdominal pressure. Patients typically present with a swelling or bulge at or near the previous surgical scar, which may increase in size with standing, coughing, or straining and may be associated with pain or discomfort. If left untreated, an incisional hernia may enlarge over time and can become incarcerated or strangulated, resulting in bowel obstruction or compromised blood supply that requires emergency surgical intervention.
Robotic incisional hernia repair is performed under general anaesthesia with the patient positioned supine. Several small abdominal incisions are made for the placement of robotic ports, through which a high-definition three-dimensional camera and robotic instruments are introduced. After docking the robotic system, the abdominal cavity is inspected, and the incisional hernia defect is identified. Adhesions between the hernia sac and surrounding tissues are carefully dissected, and the herniated contents are reduced back into the abdominal cavity. The hernia defect is then closed using robotic suturing techniques whenever feasible, followed by placement of a synthetic mesh to reinforce the abdominal wall and minimise the risk of recurrence. The mesh is securely positioned and fixed, and the peritoneum is closed over it when appropriate. Meticulous haemostasis is achieved, and a surgical drain may be placed if indicated. The robotic instruments are then removed, the specimen, if any, is retrieved through a small protected incision, and the port sites are closed, completing the procedure.