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Health Matters: Providence Cedars-Sinai Tarzana Medical Center | 9 T wo years ago, Sean Cully was a healthy, active 38-year-old Los Angeles actor who loved lifting weights, when he noticed a bulge in his groin after a workout. He had an online consultation with a physician (a COVID-19 precaution) and a CT scan, which revealed he had an inguinal hernia. This occurs when soft tissue, often a part of the intestine, bulges through a weak spot in the lower abdominal muscles, and it affects far more men than women. Cully admits he wasn't using good weight- lifting technique, but he also learned that he probably had a genetic predisposition to developing a hernia. After experiencing intermittent pain for about eight months, Cully underwent a laparoscopic hernia repair in September 2020. This is a minimally invasive procedure in which tiny instruments and a camera are inserted through small incisions. Laparoscopic procedures are a huge improvement over traditional "open" hernia surgeries, which require a larger incision, a hospital stay and longer recovery time and pose a higher risk of infection and other complications. "I had no problem with the laparoscopic surgery itself, but my recovery was difficult," Cully recalls. "I had pain afterward for about a week, and it was difficult for me to walk normally without pain medication." Four months after his hernia repair, he noticed a small hernia on the other side, something that happens in about 30% of cases. "I was very reluctant to get a second surgery because of the pain and discomfort I had after the first one," Cully says. This time, however, he underwent robot-assisted hernia repair surgery at Providence Cedars-Sinai Tarzana Medical Center, and he was far happier with his recovery process after the second surgery. "Robotic-assisted hernia repair surgery has several advantages over both traditional open surgery or even earlier laparoscopic procedures," says Nojan Toomari, DO, a leader in this specialty and in minimally invasive gastrointestinal surgeries. "It can be performed on people who have had previous hernia surgery, lower abdominal or prostate surgery, as well as on very obese people or those who have very large hernias or hernias on both sides." The advantages also include 3D imaging inside the body (as opposed to the 2D images traditional laparoscopic surgery offers), less need for pain medication and a faster recovery. "In terms of successful outcomes, complications and recurrences, our robotic-assisted hernia surgery program gets extremely high ratings compared to those at other local hospitals and is close to the top 10% nationwide," says Dr. Toomari. A KINDER, GENTLER SURGERY It's important to know that your surgeon, not the robot, performs the surgery. The surgeon sits at a console in the operating room, and the robot translates their hand movements to manipulate the instruments that have been inserted through tiny incisions. "If the surgeon's hands have any tremor at all, the robot will eliminate it," Dr. Toomari says. "In the right hands, nearly every hernia patient can be a suitable candidate for the surgery." The robot extends the doctor 's range of motion, allowing them to reach the intended area more precisely and accurately, which results in less damage to surrounding tissues. "After my robotic-assisted surgery, I was immediately able to walk normally and had almost no pain," Cully says. "I needed no medication, and my recovery was much faster and easier than after my first surgery. If I had a choice again between the two, I would definitely choose the robotic procedure." For a physician referral, please call our Patient Engagement Center at 888-HEALING (432-5464). The Surgeon's Assistant Hernia patients have less pain and a shorter recovery time with robot- assisted surgery at Providence Cedars-Sinai Tarzana Medical Center

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