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When Paul Marcus noticed an uncomfortable protruding bump in his left groin area during summer 2017, he knew right away it was an inguinal hernia.
“I had one in 1972 when I came out of the Army. It was located on the other side and repaired with surgery,” says the 68-year-old Hazleton man. An inguinal hernia occurs when tissue, such as a portion of the intestines, pops through a weak spot in the abdominal wall. It’s most common in men and is often caused by strenuous activity or lifting.
“I like to be physically active restoring classic cars and cutting down trees, so that might have caused it,” Marcus says. “When the bulge became more noticeable, I found myself being careful to not aggravate it and finally decided to get it checked out.”
Weighing surgical options
Marcus met with Lehigh Valley Health Network (LVHN)-aligned surgeon Anthony Carrato, MD, of Carrato Surgical Associates in Hazleton, who recommended surgery.
“His hernia was getting larger, and he was having some discomfort,” Carrato says. “Surgery is usually required in these cases to alleviate pain and prevent it from getting worse or causing life-threatening complications.”
Carrato presented Marcus with two surgical options. He could choose open-incision surgery, the type that repaired his first hernia 46 years earlier. Or he could have it done robotically at Lehigh Valley Hospital (LVH)–Hazleton, which was about to offer the high-tech, minimally invasive approach to treat hernias and other conditions.
Marcus chose robotic surgery to avoid a large incision and the lengthy recovery he’d experienced with his first hernia repair.
Custom care, special service
On Jan. 3, 2018, Marcus became the first patient to have a robotic procedure at LVH–Hazleton. After Marcus received anesthesia, Carrato cut three tiny half-inch holes in his upper abdomen to insert small surgical instruments and a camera. He then employed the robot’s high-resolution 3D imaging system and precise robotic arms to push the hernia’s protruding tissue back inside Marcus’ abdomen. Next, he laid a piece of synthetic mesh over the hole to reinforce the weak area in the abdominal wall. Finally, he covered the mesh with a flap of abdominal lining and sutured it shut.
“The long-term results of robotic hernia surgery appear to be as good as traditional open surgery,” Carrato says. “Plus, there’s less pain, quicker recovery time and less discomfort postoperatively.”
Jayme Lieberman, MD, Director of Surgery at LVH–Hazleton, says robotic technology provides additional benefits for patients. “Patients usually return home the same day and get back to their normal activities more quickly with robotic surgery. We’re excited to bring this technology to patients in the Hazleton area, and now offer it at all our campuses in the region.”
Marcus was not only impressed with how smoothly surgery went, he was also moved by how caring and thoughtful the nursing staff was. “I jokingly told them I’d need a cup of coffee when I came out of surgery,” Marcus says. “I went in, and the next thing I knew I was walking out of the operating room, and they handed me coffee. It was the best cup of coffee I ever had. I think it’s beyond the norm to be that considerate.”
‘Amazing’ recovery
At home later that day, Marcus took it easy, but he was surprised by how pain-free and energetic he felt. That night he experienced some discomfort, but only needed a Tylenol. By the next day he was back in his workshop doing some light car restoration work. “I wasn’t lifting anything heavy, but I never skipped a beat,” he says. “It’s pretty amazing.”
Since surgery, Marcus’ hernia has healed, and he’s now back to all his favorite activities.
“If I had to do it again, I’d definitely go with robotic surgery,” he says. “I think it was a lot simpler. I was in and out like going to the dentist, and I was on my feet and able to do stuff a lot faster.”