Approximately 350,000-500,000 ventral hernia repairs are performed each year in the United States. A hernia, in general, occurs when there is a hole in an area of weakness in the muscles of the abdominal wall, allowing a loop of intestine or abdominal tissue to push through the muscle layer, creating a balloon-like sac.
Specifically, a ventral hernia is a term that applies to all hernias that occur at any location along the midline (vertical center) of the abdomen wall, usually larger in size.
There are three types of ventral hernias:
Massive ventral hernias are those that have a length or width of at least 15 centimeters (cm) or an overall area of 150 cm2, according to the Journal of American Surgery. They pose a serious surgical risk.
Natural weaknesses in the wall of the abdomen can predispose someone to the development of a hernia at any age or any gender. Causes and risk factors of Ventral Hernias include:
Some patients do not feel any discomfort in the early stages of ventral hernia formation. The first sign is a visible bulge under the skin in the abdomen or an area that is tender to the touch. The bulge may flatten when lying down or pushing against it.
Generally, however, most patients with ventral hernias describe mild pain, aching or a pressure sensation at the site of the hernia. The discomfort worsens with any activity that puts a strain on the abdomen, such as heavy lifting, running, sitting, or standing for long periods of time, or bearing down and straining during bowel movements.
Because ventral hernias cannot heal on their own, surgery is the common treatment for Ventral Hernias. Therefore, a treatment plan with Dr. David W. Ford begins with examinations to confirm a diagnosis of Ventral Hernia. Dr. Ford will review your medical and surgical history, and also perform a physical exam of the abdominal area. Dr. Ford may then order imaging tests of the abdomen to look for signs of a ventral hernia, including an ultrasound, computed tomography (CT) scan, or a magnetic resonance imaging (MRI) study.
To determine the best surgical hernia repair method, Dr. David W. Ford considers existing medical history, age, hernia size, abdominal wall anatomy and unique shape, the patient’s available skin needed for repair, and the presence of any infections. Dr. David W. Ford tailors your hernia repair surgery to your specific situation based on the goals of the procedure and expected outcomes.
The goal of ventral hernia surgery is two-fold:
The surgery restores the tone and shape of the abdominal wall and normalizes the function of the surrounding organs, such as the intestines. The intestines will only be repaired if they have been damaged. A hernia repair is a common but major surgery with significant risks and potential complications. Larger or recurrent hernias can be very complex and require a hernia specialist, such as Dr. David W. Ford to have more knowledge, tools, techniques, and skills to tailor the best operation to your situation.
As a Board-Certified General Surgeon, Dr. David W. Ford operates with a minimally invasive robotic system to repair ventral and inguinal hernias. This minimally invasive approach only requires one or a few small incisions that doctors use to insert surgical equipment and a camera for viewing.
Robotically assisted surgery utilizes an advanced robotic platform that is not autonomous but is controlled by the surgeon who is seated in the operating room and operates via the Surgeon Console that controls the Patient Cart’s robotic devices, including various surgical instruments and a camera. The da Vinci Surgical System allows surgeons to perform various minimally invasive hernia repairs with clinically supported precision and accuracy.
Robotically assisted surgery uses a laparoscope (a thin lighted tube with a camera on the tip) that is inserted through one of several small incisions, made away from where the hernia has occurred. The images gathered from the laparoscope’s camera are high-definition 3D, which are sent to a monitor that Dr. David W. Ford uses to guide the surgical system during the operation.
If needed, the abdomen can be inflated with a harmless gas (carbon dioxide), which creates space to allow the doctor to view the inside of the body. The peritoneum (the inner lining of the abdomen) is cut to allow Dr. David W. Ford to see the weakness in the abdominal wall. Surgical mesh material is usually inserted to strengthen the weakened area in the abdominal wall. After the procedure is completed, the small incisions in the abdomen are closed with a stitch or two or with surgical tape. While robotic surgery can be used for some smaller hernias or weak areas, it can now also be used to reconstruct the abdominal wall. Dr. David W. Ford’s use of the state-of-the-art da Vinci Surgical System in his robotically assisted hernia repair surgeries has allowed him to set a very high standard of expertise that can combine this method with traditional Open Surgery if required.
Many robotically-assisted surgical systems are FDA approved and in use today. However, many are specially designed for specific organs, procedures, or conditions, such as lung or pulmonary surgeries or knee and other extremity replacement surgeries. The da Vinci Robotic Surgical System is the premier system specialized in hernia repair surgery. Dr. David W. Ford is not only an expert board-certified surgeon but also certified in the use of this leading-edge technology.
This robotic platform offers Dr. David W. Ford fully wristed instruments and a 3D high-definition camera with 10x magnification. As a result, the repair can be done with more precision, and complex hernias can be fixed with small incisions. Furthermore, the robot doesn’t get tired and Dr. Ford sits during surgery, so there is less surgeon fatigue. For the patient, this translates into quicker recovery, less pain, and fewer complications. This is the preferred approach for medium to large hernias and many inguinal hernias as it combines the best of open and laparoscopic surgeries. Also, Dr. Ford is more likely to be able to sandwich the mesh between layers of the abdominal wall to keep the mesh from coming into contact with the intestines.
Other benefits of robotic hernia surgery include:
Should robotically-assisted surgical laparoscopic surgery be recommended as part of treatment for your hernia repair, Dr. David W. Ford and his team will have the best state-of-the-art technology at their disposal to usher in your recovery.
Da Vinci surgical systems are comprised of three components: surgeon console, patient-side cart, and vision cart.
The patient-side cart is positioned near the patient on the operating table. It is where the instruments used during the operation move in real time in response to your surgeon’s hand movements at the surgeon console.
A camera provides a high-definition, 3D magnified view inside your body. Every hand movement your surgeon makes is translated by the da Vinci system in real time to bend and rotate the instruments with precision.
The vision cart makes communication possible between the components of the system possible, and supports the 3D High Definition vision system.
"The da Vinci Surgical System allows me to make smaller incisions, resulting in reduced risk of infection, minimize scarring, reduce pain, and accelerate recovery time, allowing my patients to return to normal activities more quickly."
Open surgery is the preferred method of surgery when the hernia is either very small or very complex. A complex hernia repair may require mesh removal, resection of the abdomen, or removal of extraneous skin or fat, and therefore is easier with open surgery. The open surgery requires that the incision be made in the abdomen exactly at the location where the hernia has occurred, and then the intestine or abdominal tissue is pushed back into place. Synthetic mesh material is placed to reinforce this repair and reduce hernia recurrences. The skin is then closed with dissolvable stitches and glue.
Hernia repair involves an operation, with overall one of two main approaches:
Pain management efforts are more successful if you take the medication as soon as you start to feel uncomfortable, rather than waiting until the pain is severe. Should you require a refill, please plan ahead, as we do not call in prescriptions after hours. Scheduled medication, such as narcotics, cannot be called in and must be written in person.
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