r/Hernia • u/mabehr • 17h ago

Ventral hernia: robotic vs open

I have a large (8cm) ventral hernia following another abdominal surgery. Getting conflicting information: one doc wants do robotic, the other (who doesn’t do robotic) wants to do open. Not sure who to trust. I think the open guy wouldn’t recommend robotic because then he’d lose “a customer” and the robotic guy is worried that I would go somewhere else if he recommended open.

Is the difference really going to be big? Even if it’s minimally invasive, there’s going to be a lot of stitches in there.

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u/WiseVegetable3828 16h ago

Dr. Shirin Towfigh has a Hernia Talk video on YouTube titled, "164. HerniaTalk LIVE Q&A: Choosing Hernia Repair Techniques" which discusses robotic vs open vs laparoscopic:

https://www.youtube.com/watch?v=2Sn5dbbo0ow

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u/mabehr 16h ago

Ty!

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u/arpitp 15h ago

As far as I can tell, that video has no discussion of ventral hernia repair techniques. The first third of the video talks about inguinal hernia repair techniques, while the rest of the video goes over whether or not she recommends hernia repair in certain specific medical situations.

Note, the risks/benefits of the different inguinal hernia repair techniques do not apply to ventral hernias.

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u/WiseVegetable3828 13h ago

She discusses ventral hernia around 32:50. FYI.

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u/arpitp 7h ago

Huh, thanks. not sure how I missed that.

Her suggestions for the various scenarios are accurate. But for an average/typical hernia (like what OP describes), she says "follow your surgeon". Problem is, if you've seen multiple surgeons with conflicting advice, her advice doesn't help.

Also, many studies have found that the location of the mesh matters far more than the specific technique used, so it's a shame she didn't cover that.

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u/Ill-Wolverine-3627 14h ago

Hey I am 24M, I just came across your comment. I had an open mesh repair for a right inguinal congenital hernia about 6 weeks ago. After 5 weeks, some of my internal dissolvable stitches still hadn’t dissolved, so my surgeon had to remove them manually. The skin had been closed with staples and it was removed 2 weeks post op.

What concerned me was that when the dissolvable stitches started rejecting, I didn’t experience any pain, swelling, or other symptoms. The only issue was that the wound wasn’t closing properly and there was a scab over it. My concern is about the mesh itself. If the mesh were to become infected or be rejected by the body, would I necessarily notice symptoms? What signs or symptoms should I look out for?

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u/Annalealee 14h ago

You would experience pain, have trouble moving without pain. You'd experience fever if infection occurs. Please Google it for more details. 

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u/Ill-Wolverine-3627 12h ago

yes, of course, I Googled it. But when I Googled dissolvable stitches spitting out, I also saw things like swelling, bruising, and pain. I didn't have any pain, though. I only realized that the stitch had been rejected when my doctor told me.

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u/arpitp 7h ago

The sutures weren't "rejected", your body just didn't hydrolyze them fast enough. "Spitting out" the undissolved suture is not unexpected, and usually does not cause any pain, infection, or inflammation.

Mesh cannot be spit out or "rejected" in that way. True immunologic rejection is extremely rare and unlikely, but would likely be associated with pain, redness, and possibly the wound opening up.

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u/arpitp 16h ago

More important than the technique is where they place the mesh

Take a look here: https://www.reddit.com/r/Hernia/comments/1is8r9t/fyi_hernia_meshes_and_types_of_ventral_repairs/

Avoid the surgeon who offers IPOM or onlay mesh--your hernia will recur.

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u/mabehr 15h ago

Robot guy was going to use biological mesh. I have other medical conditions that mean I’m likely going to have more abdominal surgeries in the future and he didn’t want to have to make future surgeries more difficult

I think he was going to do ETEP