Is it difficult to get a robotic umbilical hernia repair & a diastasic repair with a poss mesh?

Question

I am having surgery at cornell ny & nervous of all the mesh lawsuit commercials.

Scott Reis, MD · Answer

I'm a little uncertain what your question is based on the wording, but I'll answer you for both possibilities. If you're asking if you can have both a robotic umbilical hernia repair and a robotic diastasis repair +/- mesh, the answer is not ideally. This is due to two factors. First, during any abdominal robotic procedure, the abdomen is blown up with air to separate all the structures and allow the surgeon to perform the procedure. However, this air also further pulls the muscles apart making proper diseases repair very difficult. Also, the ports that would be used for introduction of the robot arms, instruments and camera would most likely be on visible parts of the abdomen, not along a low incision hidden under the underwear line like a mini-tummy tuck would provide. Last, this would be exceedingly expensive to have these done robotically.
If you're asking whether it's possible to have a robotic umbilical repair and an open/traditional diastasis repair +/- mesh, the answer is technically yes, but again not ideally. If you're already having the mini yummy tuck, the surgeon(s) will be staring right at the umbilical hernia. Given that an open/direct umbilical hernia repair is as good or better than a robotic repair and the fact that the larger incision is already made (the only potential benefit or laparoscopic or robotic repair), there's no need for the robot. As in the other case, depending on robot port placement  you may have additional unhidden scars higher on the abdomen. This is regardless of the fact that a robotic repair would be far more expensive (and no better but possibly inferior) than an open repair.
Finally, if you're asking about mesh for the umbilical hernia repair, the answer is yes. The recurrence rates are lower with mesh used properly. For the rectus diastasis repair, no way. Mesh is used when  tissue is weakened, absent, and/or deficient to bridge or cover a defect. This is not the problem in rectus distasis, the midline tissue has just been stretched. A properly trained board certified or board eligible plastic surgeon can deliver a rectus diastasis repair that is plenty strong without need to reinforce with mesh, and thus avoid all of the issues with putting uneccesary foreign bodies that can often be very difficult to remove in your body. Hope this helps

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  It is possible to have these surgeries combined into the same surgical setting.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Brian A. Pinsky, MD, FACS · Answer

Hello, thank you for your question. It is possible to combine a tummy tuck and hernia repair surgeries, and this is something that is done routinely.  The repair of the muscle separation may also decrease the chance of the hernia re-occurring.  There may or may not be a benefit to performing the hernia repair laparoscopically, and this is something you should discuss with your surgeons before surgery.  Be sure to have all of your questions answered before surgery.  There are many different types of mesh used for hernia repairs, and each have different properties and advantages. Best of luck.

Jon Ver Halen, MD, FACS (license suspended) · Answer

Hello and thank you for your excellent question. Yes, it is possible to have these multiple procedures at once. However, you need to be evaluated in person before the decision can be made. Also, your surgeons must be comfortable with the combination of procedures. Preoperative visualization and surgical simulation with the Crisalix system may help with your decision. Any treatment plan should be based on a detailed discussion with equal input from both you and your surgeon.    Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation in person with a qualified board-certified plastic surgeon. Good luck!
 
 Best,
Jon Ver Halen, MD FACS 
 Harvard educated plastic surgeon

Is it difficult to get a robotic umbilical hernia repair & a diastasic repair with a poss mesh?

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