Robotic Surgery for Abdominal Wall Hernia Repair: A Manual of Best Practices

174 Pages·2018·9.68 MB·English

by  Ricardo Z. Abdalla

Robotic Surgery
for Abdominal
Wall Hernia Repair
A Manual of
Best Practices
Ricardo Z. Abdalla
Thiago Nogueira Costa
Editors
123
Robotic Surgery for Abdominal Wall
Hernia Repair
Ricardo Z. Abdalla • Thiago Nogueira Costa
Editors
Robotic Surgery for
Abdominal Wall Hernia
Repair
A Manual of Best Practices
Editors
Ricardo Z. Abdalla Thiago Nogueira Costa
Department of Gastroenterology Department of Gastroenterology
University of São Paulo School of Medicine University of São Paulo School of Medicine
São Paulo, Brazil São Paulo, Brazil
Sao Paulo Cancer Institute at University Sao Paulo Cancer Institute at University
of Sao Paulo of Sao Paulo
São Paulo, Brazil São Paulo, Brazil
ISBN 978-3-319-55526-3 ISBN 978-3-319-55527-0 (eBook)
DOI 10.1007/978-3-319-55527-0
Library of Congress Control Number: 2017954916
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Foreword
Surgeons owe it to their patients to optimize their skill sets by staying up to date
with emerging hernia repair techniques that may enhance outcomes. Surgeons
should avoid thinking that one repair is good for all hernias and instead strive to
learn new techniques to broaden the scope of what they can offer patients.
The rise of robotic instruments and platforms to assist in the repair of all types of
hernias is upon us, achieving global penetration. Much of this rise in general surgery
is secondary to a popular explosion of robotics in hernia repair. A true visionary, Dr.
Ricardo Abdalla, performed some of the very first robotic hernia repairs in the
world, and as such he has also started one of the first robotics programs at his hos-
pital. To share what he has learned with the world, he has successfully gathered
some of the most pioneering robotic hernia surgeons from various countries to com-
pile a comprehensive overview of robotic-assisted hernia repairs and general sur-
gery procedures.
This book is essential for any surgeon who wishes to begin or to enhance their
robotic hernia experience. From learning how to start a robotic program and training
to learning expected short- and long-term outcomes following robotic incisional
hernia repairs, Dr. Abdalla’s book successfully teaches how to perform every differ-
ent hernia operation.
I have had the privilege of learning directly from Dr. Abdalla, but now through
the chapters in this book, all surgeons wishing to embark into the world of robotic
surgery can learn from him and his colleagues as well. A true robotic surgeon must
have this on his or her shelf!
New York City, NY, USA Brian Jacob
v
Preface
“Technology happens, it’s not good, it’s not bad. Is steel good or bad?” It is a question of
when barriers to the adoption of technology will be circumvented not whether it will happen.
Technology itself is morally agnostic. “I think that technologies are morally neutral until we
apply them. It’s only when we use them for good or for evil that they become good or evil.”
Andrew S. Grove, former President and CEO of Intel Corporation (1997)
The abdominal wall is a very wide part of the human body and one of its most
prevalent problems are abdominal hernias. Although these conditions are common
and taken for granted, they tend to cause major problems in the daily routine of the
patient and in their overall treatment.
The main therapy for them is the surgical method, but there is a lack of standard-
ization regarding the type of procedure, localization of the problem, size of hernia,
classification, and even the approach. With the improving surgical technology novel
techniques started to appear and gain space such as laparoscopy. It is very difficult
and challenging to consider or understand when a minimally invasive procedure
will help, get rid of, or facilitate this problem solution. These procedures are some-
times bogged down due to the instruments’ movement limitations, two-dimensional
view, and patients’/surgeons’ positioning. There is a long list of restrictions in some
procedures that could be cleared as we apply new facilities in diagnosis and prepara-
tion to preoperative issues. Robotic technology can overcome these problems in a way
that new techniques could be developed and complex hernias could be treated by
minimally invasive procedures, which was unthinkable. Fundamentals are the same.
The first step is to be familiar with the robot and its development history. That will
change a lot in the near future and we need to be prepared.
However, because robotic surgery has emerged only recently in the hernia field,
there are few standardizations regarding techniques, approaches, and overall setup.
Robotic Surgery for Abdominal Wall Hernia Repair intends to be a guide for sur-
geons who want to use this evolving method in the treatment of such a prevalent
disease. This book is composed mainly of three parts: how to build a robotic hernia
center, how to do the procedures, and the other components such as herniosis and
technical issues.
In this practical guide we invited experts in robotic hernia repair and surgical
leaders to explain the best way to organize a center in all ways, including training,
setup, and procedures. The abdominal wall and the trunk were imagined as one
vii
viii Preface
individualized compartment. We divided the hernias by location and complexity,
and each of them is explained step by step by specialists in the area from around the
world, using figures and drawings. And most of all, we didn’t forget associated
concerns such as quality of life, anesthesia, pain management, meshes, and adhesions.
Surgical practitioners who want to perform in the world with expanding technology
have to be guided to facilitate their path and Robotic Surgery for Abdominal Wall
Hernia Repair: A Manual of Best Practice is a great way to do so in the hernia field.
Sao Paulo, Brazil Ricardo Z. Abdalla
Thiago Nogueira Costa
Acknowledgments
University of São Paulo
Cancer Institute State of São Paulo – ICESP
Medical School of the University of São Paulo
Ivan Cecconello
Ulysses Ribeiro
Silvia Kobayashi
Evelise Pelegrinelli Zaidan
Clinic Engineering of ICESP
Springer
ix
Contents
Preparing a Robotic Program and Surgeon Training Regimen
for Hernia and Abdominal Wall . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Ivan Cecconello and Evelise Pelegrinelli Zaidan
Robotic Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Thiago Nogueira Costa
Robotic Repair of Upper Abdominal Hernias . . . . . . . . . . . . . . . . . . . . . . . 21
Jeremy A. Warren and Alfredo M. Carbonell
Robotic Repair of Lower Abdomen Defects . . . . . . . . . . . . . . . . . . . . . . . . . 35
Eduardo ParraDavila, Flavio Malcher, and Carlos Hartmann
Robotic Ventral Hernia Repair from a Lateral Approach . . . . . . . . . . . . . 49
Conrad Ballecer, Daniela Cocco, and Brian Prebil
Parastomal and Lateral Defects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Ricardo Z. Abdalla, Thiago Nogueira Costa,
and Cassio Eduardo Silva Gontijo
Pelvic Defects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Thiago Nogueira Costa and Ricardo Z. Abdalla
Postoperative Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Pedro Paulo Kimachi and Elaine Gomes Martins
Quality of Life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Ulysses Ribeiro Jr., Silvia Takanohashi Kobayashi,
and Alessandro Gonçalves Campolina
Anatomical Dissection for Adhesions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
Ricardo Z. Abdalla and Danniel Frade Said
Miscellaneous: Meshes and Sutures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Marcelo Furtado
xi
xii Contents
Molecular Biology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
Renato Miranda de Melo
Anesthesia for Robotic Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
Claudia Marquez Simões
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163