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Robotic Complex Hernia Repair Makes Patient’s Recovery Easy

December 21, 2022

Thomas Ottone had left his hernia untreated for about six years. It got worse and worse, larger and larger, more and more painful, until it became debilitating.

That’s when he went to see general surgeon Chike Chukwumah, MD, in the spring of this year.

“He came to me with a bilateral complex inguinal scrotal hernia,” Chukwumah said. “It involved his groin, scrotum and testicles, and his entire large intestine had shifted into his scrotum.”

> Concerned about hernias? Connect with a specialist

A hernia such as this one left untreated can become life threatening, Chukwumah said. Ottone had gone more than six years with the injury, even going through surgery and treatment for prostate cancer while he had it. It was his oncologist who finally convinced him to have it checked.

Chukwumah explained that a hernia starts out as a defect in the abdominal wall muscle. Because Ottone’s hernia grew so large over the years, the large intestine basically moved into it, becoming trapped.

More complicated than just a hernia

In order to repair the hernia, Chukwumah had to put the large intestine back in its right place, what he called its “natural anatomical location.” The surgery was tricky, he said, because the large intestine hadn’t been in its proper location for some time, and moving it back could have repercussions elsewhere, especially with the lungs. Chukwumah wanted to make sure that moving the large intestine wouldn’t put pressure on Ottone’s lungs, causing respiratory distress.

“We talked about not doing both sides at once,” Chukwumah said.

It was having the robotic surgery option that led Chukwumah and Ottone to decide to take care of the entire hernia at once. Using the robot in the Hartford Hospital operating room gave Chukwumah the precision needed to safely repair the hernia and push the large intestine back in place. The complicated surgery on July 8, 2022, lasted about five hours.

And yet, because it was robotic and therefore required only five small (about 1-inch) incisions on his abdomen, Ottone was able to be discharged from the hospital the next day, and only needed a few days of over-the-counter pain management.

> Related: Still Waiting for Your Hernia to Go Away on Its Own? 5 Hernia Myths Debunked

The best option? A robotic approach

“I also do these surgeries laparoscopically, which is also minimally invasive, but the robot has made these surgeries certainly easier,” he said. “The other option would have been a laparotomy – a surgical incision into the abdominal cavity – which is a big incision. With that option, you are looking at three to five days in the hospital. It’s a painful surgery, so the recovery can be challenging.”

“The robot is a game changer for these types of surgeries,” Chukwumah said. “There is a much lower hernia recurrence with the robot, greatly reduced postoperative complications, functional recovery happens in a quarter of the time, and pain management is non-narcotic.”

Two months after his surgery, Ottone said for all intents and purposes he feels “back to normal.” He has to be careful with lifting for a few more weeks, but he is driving and moving around well and without pain.

“I feel so much better,” he said. “I shouldn’t have waited.”

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