Management of hiatal hernia with robotic surgery

The most modern technique for the treatment of hernias includes robotic surgery with a special field of reference for the surgical treatment of hiatal hernia.

But what form of hernia is a hiatal hernia?
“The hiatal hernia is a form of internal hernia of the human body. Essentially, it is created when some intra-abdominal viscera (usually the stomach) protrudes into the chest through the diaphragm. The basic forms are sliding and paraesophageal. Their distinction concerns the part and the form of the sliding of the stomach”, explains Mr. Charalambos Spyropoulos, Surgeon, Director of the Clinic for Minimally Invasive Surgery of the Digestive System, Obesity and Diabetes – 3rd Surgical Clinic Master Surgeon in Hernia Surgery, co-director of the Center Center of Excellence in Hernia Surgery of Metropolitan General.

What are the main causes of its appearance?
The causes of hiatal hernias vary. The most common, however, which seem to be largely related to the appearance of the condition, are the following:
• The chronic increase in intra-abdominal pressure (due to cough, constipation, etc.)
• The increased contractility of the esophagus
• Smoking
• The person’s age (over 50 years old)
• Obesity
• Ascites (abnormal accumulation of fluid in the abdomen).

The most common symptoms of hiatal hernia
In cases where the hiatal hernia is small, it is very likely that it will not show any symptoms. As the condition progresses, certain symptoms appear, which initially usually do not come from the hernia itself, but from the gastroesophageal reflux that usually coexists. The most common are:
• Indigestion and dysphagia
• Bloating
• Nausea
• The burning sensation
• Burping
• Chest pain
• Arrhythmias
• Shortness of breath.

Robotic surgical treatment of hiatal hernia
The robotic treatment of hiatal hernia is the most modern and specialized method of rehabilitation. The operation is performed with the surgeon not over the patient, but sitting on a specially configured console, from which he manages the robotic system. This faithfully reproduces the surgeon’s motor commands, offering excellent movement precision and dampening normal hand tremors.

What are the advantages;
Robotic surgical access is performed using the state-of-the-art Da Vinci Xi® robotic system. Thanks to the innovative design of this particular system, excellent advantages are provided for the surgical procedure. Specifically, the robotic system:
• It allows the visualization in excellent detail of all the internal structures of the patient. This is achieved thanks to the high definition 3D color image and the use of immunofluorescent vision.
• Allows the restoration of normal anatomy by performing manipulations within the chest, thanks to the magnified vision and the long length of the robotic tools.
• Offers the surgeon the ability to perform a robust suture thanks to the freedom of movement of the articulated arms.
• Enables the surgeon to identify and separate all sensitive structures during hiatal hernia preparation (eg, esophagus, vagus nerves) without injuring them.
• It greatly facilitates the preparation of the stomach and the creation of a gastric valve, through which gastroesophageal reflux is treated.
• Ensures a better aesthetic result thanks to the small incisions made during surgery.
• It is successfully applied even to obese patients or to patients with large hiatal hernias.

“Undoubtedly, robotic surgery is a method that is here to stay in the field of surgery. Its significant benefits for patients and surgeons are what have made it an essential surgical tool. In any case, of course, robotic surgical access should only be performed by experienced and accredited robotic surgeons”, concludes Mr. Spyropoulos.

Written by:

Mr. Charalambos Spyropoulos, Surgeon, Director of the Clinic for Minimally Invasive Surgery of the Digestive System, Obesity and Diabetes

– 3rd Surgical Clinic Master Surgeon in Hernia Surgery, co-director of the Center of Excellence in Hernia Surgery of Metropolitan General

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