Obese Hernia

• Hiatal Hernia: The hiatus is an opening in the diaphragm, the muscular wall separating the chest cavity from the abdomen. Normally, the esophagus (food pipe) goes through the hiatus and attaches to the stomach. In a hiatal hernia (also called hiatus hernia) the stomach bulges up into the chest through that opening. There are two main types of hiatal hernias: sliding and paraesophageal (next to the esophagus).

• Inguinal Hernia: An inguinal hernia is an intrusion of the intestines into the groin area through a weak point in the abdominal wall. It can cause pain and pressure on the groin, as well as symptoms of nausea and constipation. Laparoscopic surgery for inguinal hernias involves small incisions in or just under the navel and in the lower abdomen.

• Incisional Hernia: A incisional hernia is one located on the front abdominal wall that occurs on the site of a previous surgical incision. Incisional hernias are most common in patients who have had more than one incision in the same site and who are overweight. Laparoscopic surgery offers an effective solution repairing of incisional hernias involving minimal additional incisions.

• Ventral Hernia: A ventral hernia is one located on the front abdominal wall that occurs due to the weakening of abdominal wall musculature. Ventral hernias are most common in patients who have obesity and sedentary lifestyle.

• Umbilical Hernia: In an umbilical hernia, part of the small intestine passes through the abdominal wall near the navel.

• Internal hernias after surgery: Internal hernias occur when there is protrusion of an internal organ into a retroperitoneal fossa or a foramen (congenital or acquired) in the abdominal cavity

Hernia repair can be performed using traditional open surgery or minimally invasive surgery.

• Open surgery – Surgeon make a long incision in the abdomen. The incision must be large enough for the surgeon to fit his/ her hands and surgical instruments inside the abdomen. Open surgery allows doctors to see and touch your organs and tissue while operating.
• Minimally invasive surgery – Surgeon make small openings only large enough to insert small cameras attached to robotic “rod-like” hands and arms to make repairs through these smaller openings.

1. Laparoscopy – It is done through a few small incisions using long, thin surgical instruments and a tiny camera. The camera takes images inside your body. The images are sent to a video monitor in the operating room which guides surgeons as they operate.
2. da Vinci Robotic Surgery System – Though it is often called a “robot,” da Vinci cannot act on its own. Surgery is performed entirely by Dr Abhishek Katakwar. Together, da Vinci technology allows Dr Katakwar to perform routine and complex procedures through just a few small openings, similar to traditional laparoscopy.

Who can have Minimally Invasive Hernia Surgery?

There is no contraindication except anticipated problems related to anaesthesia, abdominal tuberculosis. Though minimally invasive surgery offers many benefits over open hernia repair, may not suggest it if:
• The hernia site has had a previous infection.
• There is scar tissue damage from abdominal surgery.

How can you prepare for Surgery?

To help you make an informed decision, consider bringing questions like these to your surgeon or doctor visit:
• What medical options are available for my hernia?
• What happens if I don’t get surgery?
• What kind of experience do you have with my type of a hernia?
• Should I get a second opinion?
• What is the difference between robotic-assisted surgery and laparoscopic surgery?
• What type of anaesthesia will I receive?
• How long will the surgery take?
• Where will I have scars?
• When will I go home?
• How soon can I lift light weights after surgery? Heavier weights?

• Laparoscopic / Robotic Transabdominal Preperitoneal Inguinal Hernia Repair (TAPP)
• Laparoscopic / Robotic Total Extraperitoneal Inguinal Hernia Repair (TEP)
• Laparoscopic / Robotic Component Separation Hernia surgery
• Laparoscopic/ Robotic intraperitoneal onlay mesh (IPOM) technique
• Laparoscopic/ Robotic enhanced-view totally extraperitoneal(TEP) technique