Dr. Michael Brozik, MD, on Robotic Hernia Repair at Surgical Institute of South Dakota
May 01, 2020 03:07PM
By MED Magazine
When general surgeon Michael Brozik, MD, joined Surgical Institute of South Dakota in Sioux Falls almost three years ago, he was 'not a huge fan' of robotic surgery.
Like most new surgeons, Dr. Brozik had experience with the minimally invasive robotic approach during his surgical residency at St. Joseph Mercy Hospital in Ann Arbor, Michigan, where he also did a surgical critical care fellowship. But he admits that, at first, he did not fully appreciate the advantages of the technology.
"I changed my tune after groin hernias, though" says Dr. Brozik. "Before I was doing these robotically, many patients would still be having a lot of discomfort two weeks later."
But Brozik noticed that his robotically-repaired groin hernia patients had a completely different experience from those treated traditionally. "These patients tend to feel like they are back to normal in two weeks," he says. "Some do not even require any pain medication."
About 96% of all groin hernias are inguinal (inner groin), and most occur in men because of a natural weakness in this area. Dr. Brozik and his colleagues at SISD typically utilize a mesh scaffold to repair these hernias. As scar tissue grows into the mesh, it strengthens the repair. Hernia surgery is now the second most common operation Dr. Brozik performs, after gallbladder surgery.
Beyond the fact that the robot negates the need for a large abdominal incision, Dr. Brozik says high-definition 3D visualization allows him to see better than he can with his naked eye. As a result, he can handle internal tissues with greater delicacy, reducing trauma to the tissues and cutting pain and recovery time.
"I would say that the physicians in our group have been early adopters of minimally invasive surgical techniques," says Brozik. "Everyone here was doing robotics before I joined. We are ahead of the curve in this technology, having seen the advantages."
Dr. Brozik himself has also seen the advantages of the robot for larger abdominal procedures, including colon resections.
"I have been doing more of these with the robot and these patients have been able to leave the hospital much faster," he says. "Normally, people who have a big abdominal incision have to spend five to seven days in the hospital. But, every one of my patients who has had a colon resection done robotically has left two days after surgery."
While there is still a place for open hernia repair, Dr. Brozik says he tends to reserve it for people with very small umbilical hernias. These simple repairs can be done easily enough without the robot. In rare instances, a patient with a significant amount of scarring from previous surgeries may also not be a good robotic candidate.
"Otherwise, it is very rare that a person is not a candidate for robotic surgery," says Dr. Brozik.