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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_874_Библиотеки_им_академика_М_И_Перельмана.pdf
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- •Contents
- •1.1 Introduction
- •1.2 Ancient Past
- •1.3 Modern Period
- •1.4 Robot
- •1.5 Contemporary Period
- •1.6 Healthcare Robotics
- •1.9 Robotic-Assisted Surgery Logistics
- •1.10 Future Directions
- •1.7 Twenty-First Century
- •1.8 Hernia Repair
- •References
- •2.1 Introduction
- •2.2 Advantages
- •2.3 Disadvantages/Barriers
- •2.4 Training Requirements
- •2.6 Conclusion
- •References
- •3: Enhanced Recovery After Hernia Repair
- •3.1 Introduction
- •3.2 Pre-Operative Measurements
- •3.2.1 Smoking Cessation
- •3.2.2 Weight Loss
- •3.2.3 Diabetes Optimization
- •3.2.4 Nutritional Optimization
- •3.2.5 Prehabilitation
- •3.3 Intra-operative Measures
- •3.3.2 Perioperative Antibiotics
- •3.3.3 Surgical-Site Infections (SSI)
- •3.3.4 Improving Postoperative Intestinal Function
- •3.4 Post-operative Measures
- •3.4.2 Multimodal Pain Control
- •3.4.3 Early Enteral Feeding
- •3.5 Discussion
- •References
- •4.1 Introduction
- •4.3 Prosthetic Materials: History
- •4.4 Absorbable Synthetic Biomaterials
- •4.5 Biologic Products
- •4.5.1 Bovine Products
- •4.5.2 Cadaveric Products
- •4.5.3 Porcine Products
- •4.6 Hybrid Products
- •4.7 Flat Prosthetic Products
- •4.8 Miscellaneous Flat Products
- •4.9 Combination Flat Synthetic Prosthetics
- •4.14 Hiatal Hernia Repair Products
- •4.15 Fixation Devices
- •4.16 Conclusion
- •References
- •5.1 Inguinal Hernia
- •5.1.2 Inguinal Preoperative Imaging
- •5.1.3 Operative Approach
- •5.1.4 Laparoscopic Inguinal Hernia Repairs
- •5.1.5 Bilateral Hernias
- •5.1.6 Obesity
- •5.1.7 Anticoagulated Patients
- •5.1.8 Medical Comorbidities
- •5.1.9 Women
- •5.1.10 Femoral Hernias
- •5.1.11 Preperitoneal Mesh/Lower Midline Surgery
- •5.1.12 Scrotal/Nonreducible Hernia
- •5.1.13 Summary
- •5.1.14 Ventral/Incisional Hernia
- •5.1.16 Preoperative Imaging
- •5.1.17 Prehabilitation
- •5.1.18 Operative Approach
- •5.1.19 Mesh Utilization
- •5.2 Conclusion
- •References
- •6.1 Background
- •6.2 Pain Classification
- •6.3 Anatomic Considerations
- •6.7 Chronic Pain After Ventral Hernia Repair
- •6.8 Chronic Pain After Inguinal Hernia Repair
- •6.10 Open Extended Triple Neurectomy
- •6.11 Laparoscopic Retroperitoneal Triple Neurectomy
- •6.12 Chronic Orchialgia
- •6.14 Conclusion
- •References
- •7.1 Introduction
- •7.3 The Robotic Equipment
- •7.4.1 Patient Positioning
- •7.4.2 Cannulas
- •7.4.3 Robot Docking
- •7.5 Conclusion
- •References
- •8.6 Controversies
- •8.6.1 Direct Hernia Defect Closure
- •8.6.2 Mesh Fixation
- •8.6.3 Non-Mesh Robotic TAPP Repairs
- •8.7 Conclusion
- •References
- •8: Routine Robotic Inguinal Hernia Repair
- •8.1 Introduction
- •8.2 Patient Selection
- •8.3 Surgical Technique
- •8.3.2 Dissection
- •8.3.3 Mesh Placement
- •8.3.4 Peritoneal Closure
- •8.4 Recovery
- •8.5 Adverse Events
- •8.5.1 Small Bowel Obstruction
- •8.5.2 Recurrence
- •8.5.3 Chronic Pain
- •9.1 Introduction
- •9.2 History
- •9.3 Pre-operative Preparation
- •9.4 Operative Techniques
- •9.6 Summary
- •References
- •10: Pelvic Hernias
- •10.1 Introduction
- •10.2 Technique
- •10.5 Docking
- •10.6 Surgical Technique
- •10.7 Dissection/Adhesiolysis
- •10.8 Defect Closure
- •10.10 Complications
- •10.12 Summary
- •10.13 Concluding Remarks
- •References
- •Glossary
- •11.1 Introduction
- •11.4 Other
- •11.5 Conclusion
- •References
- •12: Re-operation After Robotic Inguinal Hernia Repair
- •12.1 Introduction
- •12.6.1 Open Repair
- •12.6.2 Laparoscopic Repair
- •12.6.3 Robotic Repair
- •12.7 Special Considerations
- •12.8 Conclusions
- •References
- •13: Botulinum Toxin Aided Hernia Repair
- •13.1 Introduction
- •13.3 Existing Clinical Applications
- •13.5.1 Anatomy
- •13.5.2 Our Technique
- •13.6.4 Other Uses
- •13.7 Conclusion
- •References
- •14: Pneumoperitoneum Aided Hernia Repair
- •14.1 Introduction
- •14.1.1 Preoperation Treatment Options
- •14.2 Progressive Preoperative Pneumoperitoneum (PPP)
- •14.2.4 PPP Protocol
- •14.3 Surgical Repair: Minimally Invasive
- •14.5 Conclusion
- •References
- •15.1 Introduction
- •15.2 Patient Selection
- •15.5 Port Placement
- •15.6 Intraoperative Considerations
- •15.7 Conclusion
- •References
- •16.2 Operative Technique
- •16.2.2 Access
- •16.2.3 Port Placement
- •16.2.5 Upper Midline Defects (Lower Dock Setup)
- •16.2.6 Lower Midline Defects (Upper Dock Setup)
- •16.2.7 Side Dock Setup
- •16.2.8 Conclusion
- •17: Robotic IPOM-Plus Repair
- •17.1 Introduction
- •17.2 Definition
- •17.3 Surgical Technique
- •17.3.1 Preoperative Care
- •17.3.2 Patient Positioning
- •17.3.3 Trocar Placement
- •17.3.4 Docking
- •17.3.5 Instrumentation
- •17.3.6 Adhesiolysis
- •17.4 Postoperative Care
- •17.5 Conclusions
- •References
- •18: Transabdominal Preperitoneal (rTAPP) Repair
- •18.1 Introduction
- •18.2 Surgical Anatomy
- •18.4 Patient Selection
- •18.5 Preoperative Evaluation
- •18.6 Equipment
- •18.7 Surgical Technique
- •18.7.2 Trocar Placement, Adhesiolysis, Preperitoneal Dissection
- •18.8 Postoperative Care
- •18.9 Complications
- •18.9.1 Bleeding-Hematoma
- •18.9.2 Seroma
- •18.9.3 Intestinal Injury
- •18.9.4 Chronic Pain
- •18.9.5 Recurrence
- •18.10 Limitations
- •18.11 Conclusion
- •References
- •19.1 Introduction
- •19.2 Background
- •19.3 History
- •19.4 Pre-Operative Workup
- •19.6 Surgical Technique
- •19.6.1 Access
- •19.6.2 Port Placement
- •19.6.3 Dissection/Adhesiolysis
- •19.6.5 Midline Reconstruction
- •19.7 Complications
- •19.9 Discussion
- •19.10 Concluding Remarks
- •References
- •Glossary
- •20: Endoscopic Component Separation Techniques
- •20.1 Endoscopic Component Separation Techniques
- •20.4 Operative Steps
- •20.4.1 Preoperative Preparation
- •20.5 Operative Technique
- •20.5.1 Transfascial Approach
- •20.5.2 Modified Subfascial Approach
- •20.5.3 Endoscopic Subcutaneous CS Approach
- •20.8 Conclusions
- •References
- •21: Robotic Retro-Rectus Repairs
- •21.1 Introduction
- •21.2 Robotic Rives: Retromuscular Repairs
- •21.2.1 Patient Selection
- •21.2.2 General Measures
- •21.2.3 Single Docking: Cranial Approach
- •21.2.4 Double Docking: Lateral Approach
- •21.2.5 Single Docking: Lateral Approach
- •21.3 e-TEP
- •21.3.3 Upper Midline Defect
- •21.3.4 Lower Midline Defects
- •21.3.5 Side-Docking
- •21.4 Conclusion
- •References
- •22: Robotic Transversus Abdominus Release
- •22.1 Introduction
- •22.2 Historical Context
- •22.2.3 The Rives-Stoppa Repair
- •22.2.4 Posterior Component Separation
- •22.2.6 Minimally Invasive Approaches
- •22.2.7 Operative Considerations
- •22.2.8 Patient Selection
- •22.3 Pre-Operative Planning
- •22.4 Technique
- •22.4.3 Trocar Placement
- •22.4.4 Docking
- •22.4.5 Retromuscular Dissection
- •22.4.6 Transversus Abdominis Release
- •22.4.8 Contralateral Dissection
- •22.4.9 Fascial Closure
- •22.4.11 Post-Operative Care
- •22.5 Conclusions
- •References
- •23.1 Introduction
- •23.2 Operating Room Set Up
- •23.3 Surgical Technique
- •23.4 Postoperative Care
- •23.5 Conclusion
- •References
- •24: Lumbar Hernia
- •24.1 Introduction
- •24.1.1 Historical Background
- •24.1.2 Classifications
- •24.1.3 Surgical Anatomy
- •24.1.4 Pathogenesis
- •24.1.5 Clinical Presentation
- •24.2 Preoperative Planning
- •24.3 Operative Technique
- •24.3.1 Open Approach
- •24.3.2 Mimimally Invasive Approach
- •24.3.2.1 Conventional Laparoscopy
- •24.3.2.2 Robotic Assisted
- •24.3.3 Hybrid Approach
- •24.4 Conclusion
- •References
- •25.1 Background
- •25.3 Preoperative Considerations
- •25.4 Operating Room Set Up
- •25.5.2 Transversus Abdominis Release (TAR)
- •25.5.4 Mesh Placement
- •25.6 Postoperative Management of Modified Sugarbaker with TAR
- •25.7 Complications
- •25.8 Traditional Sugarbaker Repair
- •25.8.1 Operating Room Set Up
- •25.9 Postoperative Management
- •25.10 Conclusion
- •References
- •References
- •27.2 Obesity
- •27.3 Malnutrition
- •27.4 Immunosuppression
- •27.5 Age
- •27.6 Special Considerations: Cytoreductive Surgery
- •27.7 Future Thoughts
- •References
- •28.1 Morgagni Hernia
- •28.1.1 Si
- •28.1.2 Xi
- •28.2 Bochdalek Hernia
- •28.2.1 Si
- •28.2.2 Xi
- •28.3 Traumatic Diaphragmatic Hernia
- •28.4 Summary
- •References
- •29: Robotic Assisted Morgagni Hernia Repair
- •29.1 Introduction
- •29.2 Preoperative Evaluation
- •29.3 Patient Selection
- •29.6 Intraoperative Considerations
- •29.7 Recommended Instruments
- •29.8 Postoperative Care
- •29.9 Conclusion
- •References
- •30: Robotic Paraesophageal Hernia Repair
- •30.1 Introduction
- •30.2 Preoperative Evaluation
- •30.2.1 Upper Endoscopy
- •30.2.2 Barium Swallow
- •30.2.3 High Resolution Esophageal Manometry
- •30.2.4 pH Monitoring
- •30.3 Operative Technique
- •30.3.1 Operating Room (OR) Setup
- •30.3.2 Patient Positioning
- •30.3.3 Trocar Placement
- •30.3.4 Docking
- •30.3.5 Visualization
- •30.3.7 Esophageal Lengthening
- •30.3.8 Crural Closure
- •30.3.9 Relaxing Incisions
- •30.3.10 Fundoplication
- •30.3.11 Mesh Reinforcement
- •30.4 Peri-Operative Complications
- •30.4.1 Pneumothorax
- •30.4.2 Vagal Injury
- •30.4.3 Esophageal Perforation
- •30.4.4 Gastric Perforation
- •30.4.5 Bleeding
- •30.4.6 Dysphagia
- •30.4.7 Reflux
- •30.5 Outcomes
- •30.6 Reoperative Considerations
- •30.9 Conclusion
- •References
- •31.1 Introduction
- •31.2 Surgical Indications
- •31.3 Preoperative Evaluation
- •31.4 Surgical Technique
- •31.5 Postoperative Care
- •31.6 Outcomes
- •31.7 Conclusion
- •References
- •32.4 Organ Perforation
- •32.6 Postoperative In-hospital Complications
- •32.7 Late Complications
- •32.8 Conclusion
- •References
- •33: Reoperation After Robotic Diaphragmatic Hernia Repair
- •33.1 Introduction
- •33.6 Open Repair
- •33.7 Laparoscopic Repair
- •33.8 Robotic Repair
- •33.9 Conclusions
- •References
- •Index

Robotic Assisted
Hernia Repair
Current Practice
Karl A. LeBlanc
Editor
123

Robotic Assisted Hernia Repair

Karl A. LeBlanc
Editor
Robotic Assisted Hernia
Repair
Current Practice

Editor
Karl A. LeBlanc
Our Lady of the Lake Physician Group
Baton Rouge, LA
USA
ISBN 978-3-030-23024-1 ISBN 978-3-030-23025-8 (eBook)
https://doi.org/10.1007/978-3-030-23025-8
© Springer Nature Switzerland AG 2019
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of
the material is concerned, specically the rights of translation, reprinting, reuse of illustrations, recitation,
broadcasting, reproduction on microlms or in any other physical way, and transmission or information
storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology
now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specic statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information in this book
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the
editors give a warranty, expressed or implied, with respect to the material contained herein or for any
errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional
claims in published maps and institutional afliations.
This Springer imprint is published by the registered company Springer Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

This textbook is dedicated to my wife,
Zinda. Without her support over all these
years, I could not have accomplished what
I have in my career.

Contents
Part I General Topics
1 Robotic Technologies (Past, Present and Future) . . . . . . . . . . . . . . . . . . 3
Brian S. Peters, Priscila R. Armijo, and Dmitry Oleynikov
2 Adoption of Robotic Technology in Surgical Practice . . . . . . . . . . . . . . 29
Ekatarina Elliott, John J. Hall, Erik B. Wilson, Shinil K. Shah,
and Melissa M. Felinski
3 Enhanced Recovery After Hernia Repair . . . . . . . . . . . . . . . . . . . . . . . . 37
Frederik Berrevoet
4 Prosthetic Materials for Robot-Assisted Hernia Repair . . . . . . . . . . . . 53
Karl A. LeBlanc
5 Algorithm of Open/Laparoscopic/Robotic Repair . . . . . . . . . . . . . . . . . 135
Archana Ramaswamy
6 Etiology and Management of Hernia- Related Chronic Pain:
Implications of Robotics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Ian T. MacQueen and David C. Chen
Part II Inguinal Hernia
7 Operating Room Set Up for Robotic Assisted
Inguinal Hernia Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
Aldo Fafaj and Ajita Prabhu
8 Routine Robotic Inguinal Hernia Repair . . . . . . . . . . . . . . . . . . . . . . . . 177
Joseph Dux, Loic Tchokouani, Erica D. Kane, and Brian P. Jacob
9 Robotic Repair of Giant Inguinal Hernias . . . . . . . . . . . . . . . . . . . . . . . 189
David S. Edelman
10 Pelvic Hernias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197
Ricardo Zugaib Abdalla and Thiago Nogueira Costa
vii

viii
Contents
11 Adverse Events of Robotic Transabdominal Preperitoneal
Inguinal Hernia Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
Matthew Sharbaugh, Liam Knott, and T. Paul Singh
12 Re-operation After Robotic Inguinal Hernia Repair . . . . . . . . . . . . . . . 221
Jordan A. Bilezikian, Robert G. Johnson, and William W. Hope
Part III Ventral and Incisional Hernia
13 Botulinum Toxin Aided Hernia Repair . . . . . . . . . . . . . . . . . . . . . . . . . . 231
Talar Tejirian and Louise Yeung
14 Pneumoperitoneum Aided Hernia Repair . . . . . . . . . . . . . . . . . . . . . . . 243
Yohann Renard, Cheryne Hammoutene, and Jean-Pierre Palot
15 Operating Room Setup and Intraoperative Considerations
for Robotic Ventral Hernia Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 259
Jefferson Tyler Watson and Karl A. LeBlanc
16 Diastasis Recti: Robotic Extended-View Totally
Extraperitoneal (eTEP) Access Hernia Repair Technique . . . . . . . . . . 267
Igor Belyansky, Richard Lu, and Alex Addo
17 Robotic IPOM-Plus Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277
Eduardo Parra-Davila, Carlos Hartmann, and Juan Maldonado
18 Transabdominal Preperitoneal (rTAPP) Repair . . . . . . . . . . . . . . . . . . 287
Fahri Gokcal and Yusef Kudsi
19 Stapled Closure for Mid-Line Hernia Repair . . . . . . . . . . . . . . . . . . . . 303
Thiago Nogueira Costa and Ricardo Zugaib Abdalla
20 Endoscopic Component Separation Techniques . . . . . . . . . . . . . . . . . . 319
Jorge Daes
21 Robotic Retro-Rectus Repairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 331
Flavio Malcher, Leandro Totti Cavazzola, and Igor Belyansky
22 Robotic Transversus Abdominus Release . . . . . . . . . . . . . . . . . . . . . . . . 351
David Bernstein and Garth R. Jacobsen
23 Subxiphoid and Suprapubic Hernia Repair . . . . . . . . . . . . . . . . . . . . . . 371
Karl A. LeBlanc
24 Lumbar Hernia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 383
Maamoun Harmouch and Karl A. LeBlanc
25 Robotic-Assisted Parastomal Hernia Repair: Sugarbaker
Repair (With and Without Component Release) . . . . . . . . . . . . . . . . . . 399
Alex Addo, Richard Lu, Igor Belyansky, and Karl A. LeBlanc

Contents
26 Robotic Ventral and Incisional Hernia Repair:
Management of Adverse Events. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 417
Anthony M. Gonzalez and Rodolfo J. Oviedo
27 Incisional Hernia in Oncologic Surgery . . . . . . . . . . . . . . . . . . . . . . . . . 425
John M. Lyons III
Part IV Diaphragmatic Hernia
28 Operating Room Set Up in the Repair of
Diaphragmatic Hernia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 439
Elizabeth Colsen
29 Robotic Assisted Morgagni Hernia Repair . . . . . . . . . . . . . . . . . . . . . . . 445
Francesco M. Bianco, Yevhen Pavelko, and Antonio Gangemi
30 Robotic Paraesophageal Hernia Repair . . . . . . . . . . . . . . . . . . . . . . . . . 457
Robert F. Cubas, Joslin N. Cheverie, and Santiago Horgan
31 Magnetic Sphincter Augmentation for
Management of Gastroesophageal Reflux Disease . . . . . . . . . . . . . . . . 475
Mark G. Hausmann and Karl A. LeBlanc
32 Adverse Events in Robotic Assisted Hiatal Hernia Repair . . . . . . . . . . 489
Alexander C. Mertens and Ivo A. M. J. Broeders
ix
33 Reoperation After Robotic Diaphragmatic Hernia Repair . . . . . . . . . . 501
Jordan A. Bilezikian, Robert G. Johnson, W. Borden Hooks III,
and William W. Hope
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 509

Part I
General Topics

Robotic Technologies (Past, Present
andFuture)
BrianS.Peters, PriscilaR.Armijo, andDmitryOleynikov
1.1 Introduction
Surgical robotic technologies and their ancillary systems have been proposed to
improve patient outcomes via shorter recoveries and limited scarring while allowing
surgeons increased dexterity and visualization [1]. The prototype for discussion of
modern robotic systems capable of application in the surgical theater is the da Vinci,
a well-established platform whose development dates to the turn of the century.
Additionally, implementation of and demand for robotic surgical platforms has
fueled growth in the sector leading to an increase in the number of products in
development as well available for purchase. General surgery trends indicate movement toward minimally invasive procedures when available, many of which are well
suited to robotic-assisted surgical platforms [2].
With each new implementation of a robotic-assisted surgical platform, the
foothold technology has secured in the operating theater strengthens. Therefore,
to understand the general picture and survey the minimally invasive roboticassisted surgery landscape, a historical review of the origins of these entities is
indicated. Here the critical developments, evolutionary phases, adverse events,
cost of development and purchase, as well as barriers to care and training will be
1
B. S. Peters
College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
P. R. Armijo
Center for Advanced Surgical Technology, University of Nebraska Medical Center,
Omaha, NE, USA
D. Oleynikov (
Center for Advanced Surgical Technology, University of Nebraska Medical Center,
Omaha, NE, USA
Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA
e-mail: doleynik@unmc.edu
© Springer Nature Switzerland AG 2019
K. A. LeBlanc (ed.), Robotic Assisted Hernia Repair,
https://doi.org/10.1007/978-3-030-23025-8_1
*)
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