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Laparoscopic or robot assisted surgery without a mesh?
If you want a laparoscopic surgery, then you get a mesh. If you want robot assisted surgery, you get a?… mesh! If you want open surgery! Then you can get it with or without a mesh.
Are there any surgeons that offer laparoscopic or robot assisted surgery without the use of a mesh? What’s the problem of doing a key hole surgery without a mesh?
I imagine that robot assistance would allow for such surgery, after seeing the demo videos of systems like da Vinci where they demonstrate peeling off the skin of a grape. But I guess the real world use of such a system is much more restricted. A hernia is simply not a grape that you can peel the inner layers off of, push the intestine back in and suture everything back together. The real benefit of a robotic system is that it makes the operation easier for the surgeon, compared to traditional laparoscopy.
So robot assisted Shouldice or Desarda is a fantasy?…
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2 Replies
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http://surgery.ucla.edu/hernia/our-expert-team [h=2]David Chen, MD does it without mesh but Laparoscopic..[/h]
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Dr Shirin Towfigh apparently offers a laparoscopic no-mesh repair to select patients, I do not know what the criteria is, or if it applies to all hernia types (indirect, direct, femoral).
Dr Todd Ponsky is also apparently researching a laparoscopic no-mesh repair for indirect hernia, again I do not know the criteria but I do know it is limited.
Interestingly, children can often get a laparoscopic no-mesh repair and it is one of the standard pediatric repairs, using a looped suture to close the inguinal ring internally, but I think it also only applies to the indirect hernia. Supposedly the recovery period is very fast with very low risk.
This is all based on information gathered from these forums, which [USER=”935″]drtowfigh[/USER] runs, so she may have some additional insight into these questions.
If you adventure around on YouTube you can also stumble upon some other rare videos of attempts at laparoscopic repairs without a mesh. I recall seeing one with a doctor in Venezuela repairing a femoral hernia without mesh using a laparoscope.
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