removal of inguinal mesh by robotics and neurectomy

[DrEarle]

I agree with everything Dr. Szotek said. I used to be a Medical Officer for the FDA working in the group that regulates robotic assisted surgical devices.and my opinion is there are two ways to look at surgical approaches – minimally invasive or not. For example, sometimes it a less invasive to use a traditional open technique, like when repairing a small belly button hernia. The robotic device company d only a tool that helps us provide a minimally invasive technique when it might not otherwise be possible. Mesh removal after laparoscopic groin hernia repair is one of those operations that the robotic device can be very helpful for the surgeon, but make no mistake, there is nothing magic about the tool. Remember each case is unique.

[pszotek]

Brunog

Thanks for your question. I often remove mesh open and via the DaVinci robot. Can you elaborate further on “nerve damage”?

Often when we remove mesh anteriorly through open incision a neurectomy is performed. When we remove mesh that was place laparoscopic or via the DaVinci robot neurectomy can be variable depending on the specific case. In addition there are different levels of neurectomy as if a nerve is involved with a mesh it will usually come out with that mesh removal. To add formal robotic neurectomy proximal to the mesh is dependent on the situation.

Thanks!
Dr. Paul Szotek
Indiana Hernia Center
http://www.indianahernia.com