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JHAH Conducts First Robotic Hernia Surgery of its Kind in Saudi Arabia
A JHAH surgeon successfully completed a robotic advanced ventral hernia repair with diastasis recti reconstruction, a first for the Kingdom.
A surgeon at Johns Hopkins Aramco Healthcare (JHAH) has conducted the first robotic hernia procedure of its kind in Saudi Arabia.
Dr. Emad Sherkawi, a general surgery consultant, successfully completed an advanced ventral hernia repair with diastasis recti reconstruction using a da Vinci surgical robot.
It is the first time that the procedure has been conducted in the Kingdom, according to Gulf Medical, the exclusive supplier of the da Vinci robot to healthcare providers in the Gulf.
The surgery was performed under the supervision of Dr. Hien Nguyen, Director of the Comprehensive Hernia Center at Johns Hopkins Medicine, Baltimore. Dr. Nguyen is a regular visitor to JHAH Dhahran as part of the hospital’s surgical rotation program.
The successful completion of the novel procedure is another leap forward for JHAH’s flourishing robotic surgery program. JHAH’s da Vinci robot is the busiest in Saudi Arabia, having conducted 602 procedures in the 18 months to June this year — more than any other single system in the Kingdom — according to Gulf Medical.
A ventral hernia is a protrusion of the intestine or other tissue through a gap in the abdominal wall. Robotic ventral hernia repair, a form of minimally invasive surgery, is a relatively new procedure that has been conducted by only a handful of surgeons globally.
Robotic surgery has notable benefits over open surgery. It means that patients require significantly smaller incisions, endure less pain, are discharged from hospital faster, and spend much less time recovering.
A patient undergoing open surgery for hernia repair will need to stay in hospital for five to seven nights and will need between four and six weeks to recover,
With robotic hernia repair, the patient’s hospital stay will typically be one or two nights, and they should be back to normal activity within 10 to 14 days.
To conduct robotic hernia repair, a patient is first placed under general anesthesia. The surgeon then makes a tiny skin incision to insert a small tube through the patient’s abdominal wall. A 3D camera, which is connected to the da Vinci robot, is inserted through the tube. After inspecting the abdominal cavity with the camera, a further two small tubes are inserted through the abdominal wall. These additional tubes, which are also connected to the da Vinci robot, act as pathways for the instruments required for surgery, such as forceps and scissors.
The surgeon sits at a console that gives them a 3D view from inside the patient’s body and uses the controls on the console to guide the precise movements of the robot’s arms. After conducting midline abdominal dissection to identify the edges of the hernia within the abdominal muscles, the surgeon repairs the hernia by inserting a mesh lining. The mesh ensures that the abdominal contents remain within the abdominal cavity and prevents further hernias developing. Surgery typically takes between two and three hours.
“For female patients who develop separation of the abdominal muscles during pregnancy or delivery, robotic ventral hernia repair carries significant advantages over open surgery,” Dr. Sherkawi explains. “Separation of the abdominal muscles is tricky to repair, and may require an abdominoplasty with flank-to-flank incision — a difficult and uncomfortable procedure that requires an incision of about 30 cm.
“With the robot, we need only create three small incisions of about 8 mm each, and we can perform reconstructive surgery from there.”