Dan Slagle is a spry, energetic 74-year-old with “a stubborn streak” that he says ultimately got in the way of his being able to live a normal life. “If others are willing to listen to my story,” he said, “hopefully they will avoid what I went through.”
Dan, a former Coast Guard engineer, was enjoying an active retirement, spending a lot of time on his gold mining hobby, installing off-grid solar systems, out and about with his two grandsons and enjoying long walks with his German Shepherd, Chevy.
Then he developed an inguinal hernia in 2019. An inguinal hernia occurs when connective tissue has a defect, essentially a hole in the abdominal wall, allowing contents such as intestines to protrude or become trapped. The resulting bulge can be painful, especially when coughing, bending over or lifting heavy objects.
Not necessarily a dangerous condition, it won’t improve on its own, and can even lead to life-threatening complications. At first Dan ignored it, stubbornly. But, over months it became much more than a nuisance.
“I would have to lay down five, six, seven, 10 times a day to push the hernia back in,” he explained.
It was also affecting how long he could ride in a car, stand up, or take Chevy for a mile-long walk.
“One day, in the middle of one of our walks, I had to lay down on the trail to push the hernia back in. My dog was going crazy, and it was embarrassing. That’s when I knew I had to get this fixed.”
He started researching hernias, what causes them and how they can be repaired. “Inguinal hernias, like Dan’s, can be treated with an open incision over the groin area, or using minimally invasive techniques such as laparoscopic or robotic surgery,” according to NorthBay general surgeon William Fulton, D.O. “The robotic technique is very similar to laparoscopic, but the ability to dissect, visualize and assure appropriate repair is significantly improved.”
“I knew from my research that I wanted it to be repaired through robotic surgery,” Dan explained.
Robotic surgery offers patients a shorter recovery time, less pain and less risk of blood loss.
“So, I started researching where in our area robotically trained surgery is offered and who performs them,” Dan said, “and was stinkin’ lucky to learn they do it right here at NorthBay!”
NorthBay Health is the first healthcare provider in the area to invest in surgical robotics, having acquired the da Vinci Xi system in the fall of 2019.
“The da Vinci Xi robot is absolutely perfectly designed for inguinal hernia surgery,” Dr. Fulton said. “Its major advantages are preventing recurrence and decreasing pain in the post-operative period. They also create smaller incisions. Obese and overweight patients benefit significantly from minimally invasive surgery because we avoid dissecting through deep subcutaneous tissues, which can lead to fluid build-up, infection and longer healing.”
The da Vinci system allows surgeons to perform complex and delicate procedures – such as hernia repairs, gall bladder removal, hysterectomies, nephrectomies and prostate surgeries -- with exceptional precision.
The da Vinci includes a 3D high-definition camera and mechanical arms with surgical instruments attached to them. The surgeon controls the arms while seated at a computer console near the operating table, while the rest of the surgical team is at the patient’s bedside.
The robotic system’s advanced technology provides the surgeon with a better view of the operating field and better access to the surgical site. The surgeon’s movements on the console are translated into very precise movements on the robotic arms, which offers greater dexterity for delicate procedures.
Ventral and inguinal hernias are not the only surgical procedure to be performed using the Da Vinci robot. “We can perform gallbladder and colon surgery, prostatectomy and nephrectomies, as well as hysterectomies and other pelvic/ovarian procedures,” according to urologist Herkanwal Khaira, M.D.
“Some patients, like Dan, come to the clinic with a very clear understanding of what robotic surgery involves and request this technique. As patients learn about robotic surgery, they understand that this is not a robot on autopilot, but rather an advanced tool for the surgeon to control,” Dr. Fulton said.
When Dan met Dr. Fulton to discuss his options, he was impressed with his demeanor and professionalism.
“He didn’t rush me and wasn’t in such a big hurry that he kept looking at his watch,” he said. “He explained what he could do with the Da Vinci robot, asked if I was OK with that and I said ‘heck, yeah!’ He also personally walked me over to scheduling to check availability and schedule the surgery.”
On the morning of his surgery, Dan said everything went smoothly.
“As I was wheeled into the surgical suite, everyone seemed to be in a good mood for a Monday morning, I looked at that cool-looking robot, asked a few questions and then, lights out! A short time later, lights back on! The nurse called my wife, Dawn, who was there to take me home. I was home by noon!”
Dan says he had three tiny incisions, didn’t experience any real pain, and had just minor discomfort.
“On the third day after surgery, I walked the dog again, but it was just a short walk. The next week I was back to gold mining. Six weeks later, I’m shoveling dirt, and moving in a new stove at home. It was all better than I expected. The quality of my life just made a dramatic improvement. I am a happy camper. And I hope that others, who are putting off getting a hernia repaired, don’t wait like I did.”
NorthBay Health has five surgeons on staff who are trained and certified to use the da Vinci Xi Robotic surgical system. They are: General Surgeons William Fulton, D.O., and Majid Kianmajd, D.O; Herkanwal Khaira, M.D., urologist; and OB/GYN physician Kalie Li, D.O.
Depending on their specialty, surgeons can perform nephrectomies, prostate and hernia surgery, hysterectomies, oophorectomies (ovary removal), myomectomies (fibroid removal), ovarian cystectomies, cholecystectomies (gallbladder or gallstone removal), and colectomies (partial removal of colon).
How a Hernia Happens
In many people, the abdominal wall weakness that leads to an inguinal hernia occurs at birth when the abdominal lining (peritoneum) doesn't close properly, according to the Mayo Clinic. Other inguinal hernias develop later in life when muscles weaken or deteriorate due to aging, strenuous physical activity, coughing that accompanies smoking, or after an injury or abdominal surgery.
Signs and symptoms include:
- A bulge in the area on either side of your pubic bone, which becomes more obvious when you're upright, especially if you cough or strain
- A burning or aching sensation at the bulge
- Pain or discomfort in your groin, especially when bending over, coughing or lifting
- A heavy or dragging sensation in your groin
- Weakness or pressure in your groin
- Occasionally, pain and swelling around the testicles when the protruding intestine descends into the scrotum