One of the ways that hernias are becoming even more routine is through the use of robotic surgery. There are more hernia surgeries than ever being performed in the U.S. Now, there are roughly 800,000 procedures done in the U.S. each year. Hernia surgeries are easier than ever, although easy does not necessarily mean safe. The doctors who perform this robotic surgery argue that it has real benefits for patients. However, the benefits to a robotic surgery in the short run may be tempered by the fact that these procedures use hernia mesh exclusively.

robotic mesh surgery

robotic hernia mesh surgery

Dr. Aaaron Epstein Is a Frequent Practitioner of Robotic Hernia Surgery

Dr. Aaron Epstein performs most of his hernia surgeries using the robotic technique. He does 300 hernia surgeries each year so his robotic machine is quite busy.  Robotic hernia surgery means that the machine is assisting the surgeon is repairing the hernia. Instead of using the surgical instrument and making the incisions themselves, the surgeon sits behind the console and manipulates the controls. The surgeon will have less physical contact with the patient and will interact more with the machine during surgery.

100 hours of additional training

Dr. Epstein is adamant that robotic surgery does not mean that he is taking it easy in the operating room while the machine does all the work. He stresses that robotic surgery still means that he is in control in the operating room and that the machine is merely assisting him in performing surgery. Dr. Epstein explains that surgeons must have 100 hours of additional training just on the use of the machine. Before they are allowed to use the surgery to operate on humans, they must perform five procedures on pigs and an additional five operations using a cadaver.

The Advantages of Robotic Surgery

In the meantime, there definitely are some advantages to robotic hernia surgery. These procedures result in less of a chance of blood loss for the patient. In addition, the patient has a shorter recovery time, meaning they are back on their feet in less time. Further, the surgeon’s job is made easier because they have a 3D view of the area as opposed to the 2D vantage point that they would get in standard hernia surgery.

Dr. Epstein claims that hernia mesh surgeries are completely safe

In spite of mounting evidence to the contrary, Dr. Epstein claims that hernia mesh surgeries are completely safe. He believes that the fear of hernia mesh surgery has been largely created by lawyers and contradicts the actual numbers. In fact, he calls talk of hernia mesh being dangerous “lawyer sorcery” and argues that doctors do not have any issue with the use of hernia mesh. Of course, hernia mesh surgeries are billed as routine and are easier for doctors to perform as evidenced by the robotic surgery that Dr. Epstein performs.

Other doctors have argued that there is not much research that backs up the fact that robotic surgery is the best option. While this type of surgery is not any more dangerous and has its advantages, the benefits of the surgery are not documented.

Robotic Surgery Is a Money-Maker

What is known is that robotic surgery is more expensive than laparoscopic hernia surgery. The surgery on average costs about 60 percent more. Part of the cost is for the advanced medical equipment, but this type of surgery is also more profitable for doctors. Doctors can perform more surgeries with less work required at a higher cost. However, Dr. Epstein explains that robotic surgery does not cost the patient more because Medicare codes robotic surgery the same way as it does standard hernia procedures.  In addition, robotic surgeries may also take longer than standard hernia mesh surgery and can require more operating room time.

Diagnostic properties of the robotic machine

Perhaps as a result of the benefits of performing a multitude of high-cost “easy” surgeries, hospitals are now even marketing hernia surgeries to potential customers. Some hospitals are taking advantage of the diagnostic properties of the robotic machine to offer free hernia screenings to possible patients. Some hospitals are combining this with a warning of the consequences if a hernia is left untreated to persuade the patients to opt for hernia surgery. In some cases, this could lead to patients getting unnecessary surgeries. In addition, it could open up more patients to suffer the side effects of hernia mesh since that is what is exclusively used in robotic hernia surgeries.

Long-term side effects

In fact, some have questioned the need for more widespread hernia operations given the complications associated with hernia operations. Even if the operation goes smoothly and the initial recovery time is shortened, it does not lessen the long-term complications and side effects. In fact, roughly 12 percent of hernia patients will suffer over the long run. These complications can set in months or even years after the initial surgery.

Precision afforded by robotics

Robotics may also make it easier for more different types of patients to have hernia surgery. Patients who are obese or have other health conditions may not be a candidate for hernia surgery. However, the precision afforded by robotics makes surgery easier for them. It also assists surgeons in reaching areas that are otherwise difficult to reach on patients with certain body types.

Robotic Surgery Means More Hernia Mesh

Of course, robotic surgery also presents a risk due to its exclusive use of hernia mesh. Even if the rate of recurrence is lower, mesh surgery results in long-term danger to the patient because of the well-known side effects such as mesh shrinkage and migration. This can cause severe pain and damage to internal organs. In other words, while robotic surgery proponents cite the lower risk of complications in the short-term, patients are no more protected from the long-term side effects associated with hernia mesh than they would be for any other type of surgery.

helpful in removing hernia mesh

Where robotic hernia surgery can be helpful is in removing hernia mesh. In some cases, hernia mesh must be removed because it is causing chronic pain. Hernia mesh removal is a delicate surgery that requires precision in order to get as much of the mesh out of the body as possible. Sometimes, multiple surgeries are required to take out the mesh that has disintegrated in the body.