“Hernia” and “surgery” may sound like two scary words, but if you ask Sanford Health surgeon Joshua Knudson, M.D., they don’t have to be.
In fact, Dr. Knudson, who operates out of Bismarck, North Dakota, specializes in minimally invasive and robotic surgeries. If you’re unfamiliar with the term “minimally invasive,” it essentially means small incisions to the body – as opposed to large, deep cuts of traditional surgery – which often results in quicker recovery times for patients.
Addressing the misconceptions
Dr. Knudson said a long recovery window is a common misconception when it comes to hernia surgeries.
“I battle that misconception all day long. Not just with patients, but even with recovery nurses telling them that they can’t do certain activities for so many days or weeks. It’s just not true. The body knows when it’s ready to do something better than any of us. So, with my robotics surgeries, I tell people if it hurts, don’t do it. If you start doing stuff right away, just start light and work your way up. Listen to your body,” he said.
Along with a prolonged recovery window, Dr. Knudson said he often sees people delay hernia surgeries because of an overall fear of surgery, and mesh horror stories.
Mesh is a device placed at the time of a hernia surgery to decrease the chance of getting a hernia back. If the surgery isn’t done precisely, there have been some adverse reactions to mesh placement like pain, infection and bowel obstruction.
“With robotic hernia surgery we are able to diminish these risks,” said Dr. Knudson.
OK, but what is a hernia?
Before we get too much further into the weeds as to why hernia surgery is needed, it’s important we explain exactly what a hernia is.
Quite simply, a hernia is a hole in a patient’s belly wall.
“People commonly get swelling or a lump where the hernia is, and that is stuff from inside your belly, sticking out of the hole,” explained Dr. Knudson.
It’s tricky, because in some instances hernias are quite painful, while other times patients will only visibly see the hernia but won’t feel a thing.
“That’s how people can sit around with it for a while. The biggest worry is whatever comes out gets stuck and pinched off. And if that’s the wrong thing, like say a piece of intestine, it can die.
“If your intestine dies, you get very, very sick. It’s emergency types of surgery at that point. So, generally we want to fix these (hernias) before they turn into a medical emergency. A patient’s outcome is always going to be better if they pick a time to have surgery, rather than letting their body pick a time for them,” said Dr. Knudson.
To fix a hernia, Dr. Knudson “goes into the belly; we pull back inside anything that’s sticking out where it doesn’t belong. That will show us exactly the hole, or the hernia, and then we sew the hole shut. We reinforce underneath the hole with a mesh patch.”
Benefits of robotic surgery
Dr. Knudson said it would be hard for patients to find better hernia care outside of Sanford, thanks in large part to the health care provider’s resources, particularly the offering of robotic surgery.
The robot allows Dr. Knudson and other surgeons better closure of the hole, and to avoid mesh complications.
“The robot allows us to sew upside down, which is exceedingly difficult if you don’t have it. There are advantages to having your hernia sewn shut, rather than just patched. The other big thing is (that) most of the issues with meshes for hernias are caused by mesh being in contact with the abdominal contents, your intestines.
“We are much, much more successful with the robot because of its precision in keeping the mesh outside of the abdomen, essentially,” he explained.
Dr. Knudson said this is yet another example of the world-class care patients can expect at Sanford.
“We’re robotically treating hernias as complex as they come. There’s nothing that we aren’t doing here that’s being done anywhere from Minneapolis to Seattle. Honestly, I’m seeing referrals from other surgeons who don’t have the capability to repair complex hernias, and we’re doing it here. A lot of them we are doing on an outpatient basis. We haven’t had anybody in the hospital more than one or two days, whereas for previous hernia surgeries, people were here sometimes up to seven days.”
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