New Haven Register (Sunday) (New Haven, CT)
Four tiny incisions, a life-changing hernia operation
Albertina Baio has been through a lot in her 65 years. After surviving stage 3 ovarian cancer 15 years ago, she had hoped her hospital days were over. So when she started having to go to the emergency room once every month for excruciating pain and bowel obstructions, she knew she had to do something more permanent.
Her intestines were getting stuck and twisted through multiple holes in her abdomen: complex hernias.
“The hernia pain was up there with the cancer pain,” Baio said. “I couldn’t turn in my bed. If I turned left, I’d be screaming; if I turned right, I’d be screaming.”
During her frequent ER trips, the staff recommended Baio see Dr. Emilia Genova, a general surgeon at St. Vincent’s Medical Center who has advanced training in hernia repair.
“A hernia is a defect — a hole — in the muscles of the abdominal wall, and your insides can come through it, resulting in the bulging that the patients see,” Genova said. “There are different ways a hernia can form: strenuous activity; prior surgery; sometimes it’s even related to the way you were born.”
Genova said without an elective hernia procedure, Baio likely would’ve needed emergency surgery.
“The problem with bowel obstructions is that in an emergency surgery, we would have had complications,” Genova said. “The surgery would have been a major operation with a possible bowel resection. We were getting to the point where surgery was impending, and it is always better to do it electively when the patient
is healthy, not emergently when she is sick.”
Because they had ample time to prepare, Baio and Genova worked together. Baio lost some weight so she could undergo robotic surgery — a procedure not attempted by many doctors in the area.
“What I do is a result of a lot of training,” Genova said. “People shy away from (robotic-assisted surgery) for complex surgery, but now we can do them, and I say we do them better than if they were open.”
Since Genova specializes in this type of surgery, it puts her in high demand.
“I had another doctor who told me, ‘The way it looks in there, I don’t think any doctor will touch you,’ and I thought, ‘Oh, God, I’m going to die,’” Baio said. “Dr. Genova said she could help me if I trusted her, so I trusted her.”
“If Tina had open surgery she would’ve had major complications, and what I can offer robotically is something she wouldn’t have been able to have done somewhere else,” Genova said. “I think it’s amazing we can offer this to our patients now.”
But what is robotic
surgery?
“It’s an advanced laparoscopic surgery,” Genova explained. “We use a camera and instruments that are controlled through a console, so the surgeon goes through the computer. You have eight times magnification, you can get angles you’ll never get laparoscopically, and your motions are finer and more precise.”
But don’t let the small outer incisions fool you. The tools accomplish the same thing open surgery would, and the inner repairs are just as extensive.
“The incisions aren’t large on the outside, but the incisions are large on the inside,” Baio said. “The little holes on the outside are deceiving.”
“She had several large holes, so to repair I had to do component separation, which requires mobilizing muscles from the side of the abdomen to the midline of the abdomen to close them,” Genova said. “On the inside it’s a major reconstruction of the entire abdominal wall. Afterward, patients need to be active without straining themselves — walk, ambulate, engage in light activity.”
This is where Baio is now, just weeks after her surgery. While the pain is still there, she is already moving around and even going grocery shopping. She said her experience at St. Vincent’s was remarkable.
“Dr. Genova is an angel, and the people at St.
Vincent’s are really good people,” Baio said. “The staff is wonderful. While I was in deep pain, I slept for 16 hours straight after the surgery, but when I woke up they were always there, right next to me.”
Since every hernia patient is different their plan of care will be different, but no one should have to live in pain. In Baio’s case, elective robotic surgery provided the best outcome in both the immediate and the long term.
“Her opening incision would have been 12-15 inches long, but now she has four incisions that are a third of an inch long,” Genova said. “It’s away from outside germs so there is less chance of infection.
We were able to avoid any bowel injuries because the instruments are so small and the precision of the surgery is much greater than in an open case. Hernia surgeries aren’t often life-changing, but in Baio’s case this was absolutely life-changing.”
This is just one example of how Hartford HealthCare St. Vincent’s Medical Center brings access to more specialists and providers to the community. Tune into Hartford HealthCare St. Vincent’s Medical Center’s Facebook Live discussion, where you can ask your questions, on Thursday, Nov. 17, at noon. For more information, call 860-8276600.