scopically placed
mesh.
I presented data at
the 2015 Society of
Gastrointestinal and
Endoscopic
Surgeons (SAGES)
showing that out-
comes are better
with the robotic
technique than the
laparoscopic tech-
nique for mesh
removal and revision surgery (osmag.net/uykvh4). The visualization is
much better, so you can remove the mesh with higher precision and
you're less likely to injure any of the multiple significant vessels in the
area. In all, I've now done more than 150 cases with the robot, and
have had good outcomes with all of them.
Resisting change
Despite their advantages, it's going to be a while before we see robots
in every hospital and surgery center. Not only are they expensive, but
there are still plenty of non-believers. The same was true when
laparoscopy first came onto the scene, of course. It's hard to believe,
but surgeons were thrown out of hospitals and had their privileges
revoked because they were dabbling in laparoscopy. Minimally inva-
sive gallbladder removal — which is now done in more than 90% of
cases — was considered a really big deal.
We're going through a similar situation with the robot. Most people
who do just plain laparoscopic inguinal hernias don't see the benefit.
9 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A U G U S T 2 0 1 7
• MORE CHOICES? At the 2017 SAGES exhibit hall, Dr. Towfigh checked out what may soon be a new
entry into the U.S. robot market.
Jim
Burger
