Robotic Assisted Umbilical Hernia Repair With a Magnetic Retractor

Gerardo Davalos, MD; Daniel Guerron, MD; Dana D. Portenier, MD, FACS; Sugong Chen, MD

Product Details
Product ID: ACS-5663
Year Produced: 2018
Length: 5 min.


Background:Ventral hernia repair (VHR) is one of the most common general surgery procedures. The future of this procedure lies in minimally invasive techniques, consequently, robotic platforms seem to be evolving. Some challenges still exist. During intraperitoneal onlay mesh repair, one of the most challenging steps is opposing the mesh to the abdominal wall prior to suturing for final fixation. To mitigate this challenge, we combined the dynamic use of a robot-assisted technique and a magnetic device which allowed satisfactory opposition of the mesh and subsequent suturing. Objective: To showcase the use of an alternative transabdominal preperitoneal (TAP) hernia repair utilizing magnetic and robotic assistance. Methods: A 43 year old male with a BMI 32.22kg/m2, underwent a robot and magnetic assisted TAP umbilical hernia for a symptomatic hernia. We used robotic two 8mm ports, 12mm port camera, and a 12mm assistant port. A preperitoneal flap was created. The fascial defect was closed with running absorbable suture. A polypropylene mesh was used. A magnetic grasper was placed in the center of the mesh and then coupled to an external magnet in order to oppose the mesh to the abdominal wall thus facilitating mesh fixation and suture. Results:Operating docking time was 116min. EBL was minimal. No post-operative or short-term follow-up complications. The patient was discharged home the same day. Conclusion: Evolving technologies present new solutions for general surgery procedures. Combining robotic and magnetic surgery technology facilitates hernia surgery and mesh placement techniques. Magnetic assisted surgery also provides unconstrained, incisionless retraction during VHR.