Israeli study points to potential of robotic surgery for complex hernias
Baku, October 14, AZERTAC
Israeli surgeons have used robotic technology to repair 39 complex abdominal hernias, completing all procedures without converting to open surgery, according to TPS-IL.
The findings suggest that robotic surgery can be used to repair hernias along the side of the abdomen, an area that can be difficult to reach. No hernias recurred during a median follow-up of approximately 14 months, and patients typically spent one day in the hospital. However, complications occurred in nearly one-quarter of patients, and further research is needed to determine whether the approach offers better outcomes than conventional surgery.
A hernia occurs when tissue or part of an organ pushes through a weakened area of the abdominal wall. Lateral abdominal wall hernias develop along the side of the abdomen, rather than in the groin or near the center of the abdomen. They can enlarge and cause increasing pain and discomfort. In some cases, tissue or part of the intestine becomes trapped, potentially cutting off its blood supply and requiring emergency surgery.
Many of these hernias develop after surgery, when an incision weakens the abdominal wall. Repairing them can be challenging because surgeons must close the opening and position surgical mesh to reinforce the weakened tissue in an area surrounded by bones, muscles, nerves, and blood vessels. Previous operations can leave scar tissue and alter normal anatomy, making the procedure more complicated.
Most patients in the Israeli study had developed hernias at the sites of earlier operations involving the kidneys, colon or rectum, spine, or gallbladder.
A Robotic Approach
Open surgery may require a large incision and a longer recovery. Conventional laparoscopic surgery uses smaller incisions, but its rigid instruments can be difficult to maneuver at the angles needed to repair hernias along the side of the abdomen. Robotic surgical systems offer flexible instruments and a magnified, three-dimensional view of the operating area, potentially helping surgeons close the opening and position reinforcing mesh while limiting disruption to surrounding tissue.
The study examined 39 patients who underwent robotic repair between 2018 and 2025. It was led by Dr. Michael Freund of the Hebrew University and Shaare Zedek Medical Center, under the guidance of Prof. David Hazzan of Raphael Hospital, in collaboration with Sheba Medical Center and Tel Aviv University. The findings were published in the peer-reviewed medical journal *Hernia*.
All 39 procedures were completed robotically, without conversion to another surgical approach. The overall complication rate was 23.1%, with most complications classified as minor. The study also reported two cases of bowel obstruction requiring additional surgery. Both patients recovered without needing any part of the bowel removed.
Most patients reported little pain after surgery and were discharged after a median hospital stay of one day. No hernias recurred during a median follow-up of approximately 14 months.
“Robotic technology is changing the boundaries of what surgeons can do through small incisions,” Freund said.
The researchers cautioned that the study was retrospective, meaning it analyzed procedures that had already taken place, and included only 39 patients. It did not directly compare robotic surgery with open or conventional laparoscopic techniques.
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