Dr. Solon Gonçalves Souza Menezes
Professor of Surgery — FAMED UFU · Robotic Surgery Certification (Intuitive / Albert Einstein Hospital) · Practices at Hospital UMC and Hospital Mater Dei Santa Genoveva, Uberlândia, Brazil · +55 (34) 99341-0915
Epigastric hernia occurs at the linea alba, the fibrous band between the rectus abdominis muscles, in the region between the navel and the xiphoid process. It forms at points of weakness where vessels and nerves cross this layer, allowing protrusion of preperitoneal fat and, less often, omentum or bowel loops. It can present as a single defect or multiple nearby openings. Obesity, repetitive physical strain, chronic cough, constipation, and pregnancy, which increase intra-abdominal pressure, tend to favor its development. Many epigastric hernias are small and asymptomatic, noticed only as a discreet nodule in the upper midline of the abdomen; when symptomatic, they tend to cause localized pain that worsens with physical exertion.
Diagnosis is predominantly clinical, through palpation of the bulge, more evident with the patient standing or during the Valsalva maneuver, associated with pain or discomfort in the epigastric region. Abdominal wall ultrasound usually confirms the diagnosis, defines the size and content of the defect, and identifies multiple hernia openings, a relatively common finding in this type of hernia. In cases of diagnostic doubt or atypical symptoms, CT may complement the assessment. Since epigastric pain can also have a non-surgical origin, such as gastritis or peptic ulcer disease, the assessment seeks to distinguish between these possibilities before indicating surgical treatment. The indication for correction takes into account the size of the defect, the presence of symptoms, and the risk of incarceration of the herniated content, with the decision always individualized.
Robotic correction follows the principles of minimally invasive abdominal wall surgery: access through a few small incisions, careful dissection of the hernia sac, reduction of the protruding content, and closure of the defect at the linea alba, generally reinforced with a mesh positioned in the preperitoneal or retromuscular plane, depending on the anatomy and extent of the case. The robotic platform can offer greater suturing precision and instrument articulation, which can facilitate primary closure of the defect before mesh placement and treatment, in the same procedure, of multiple defects along the midline. The choice between robotic, laparoscopic, or open approach, and the type and positioning of the mesh, is defined case by case, according to the size and number of defects, abdominal wall thickness, and the patient's clinical condition. As a professor of surgery certified in robotic surgery through Intuitive and Hospital Israelita Albert Einstein, Dr. Solon Gonçalves individualizes the technique according to the characteristics of each case, within the limitations of any surgery.
Book a consultationWhat to expect before and after surgery.
Preoperative preparation
Preoperative preparation for robotic epigastric hernia surgery generally involves clinical evaluation and additional exams, which tend to vary according to age and each patient's health condition. Preoperative fasting is also typically recommended and, when necessary, temporary suspension of certain medications, always under individualized medical guidance. Habits such as quitting smoking and maintaining a healthy weight before surgery tend to support recovery, but specific instructions for each case should always be confirmed directly with the responsible surgeon.
Recovery and postoperative care
Recovery after robotic epigastric hernia surgery tends to be faster than with the traditional open technique, but the exact time for return to activities can vary considerably from patient to patient. In the first few days, relative rest is generally recommended, avoiding physical exertion and, when indicated, use of an abdominal binder. Gradual return to daily activities and clearance for more intense exercise are usually determined individually by the surgeon, according to each case's progress.
Common questions about this procedure.
What type of anesthesia is used in robotic epigastric hernia surgery?+
This procedure is usually performed under general anesthesia, but the most appropriate type of anesthesia is always defined by the surgeon together with the anesthesiologist, considering each patient's clinical characteristics.
How long does the surgery take?+
Duration can vary according to the complexity of the hernia and the specific features of each case; in general, this type of surgery tends to take between 1 and 2 hours, but this is only an approximate reference, not a guarantee.
Is hospitalization required? For how many days?+
In most cases, hospitalization tends to be brief, ranging from a few hours on an outpatient basis to 1 or 2 days, depending on medical assessment and each patient's progress.
How much rest is needed right after surgery?+
An initial period of relative rest is usually recommended in the first few days, avoiding physical exertion and sudden movements; the exact length of this phase is determined by the surgeon according to each patient's progress.
When is it possible to return to work?+
Return to professional activities usually varies depending on the type of work (more or less physical) and individual progress, generally occurring somewhere between a few days and a few weeks, always with prior medical clearance.
When can I drive again?+
In general, it is recommended to wait until there is no significant pain and no use of medication that impairs reflexes, which usually occurs in the first days to weeks after surgery; final clearance should be confirmed with the surgeon.
When can I resume physical exercise and gym activities?+
Light physical activities are usually resumed gradually within the first few weeks, while exercises involving more intense abdominal effort, such as heavy weight training, generally require a longer period, to be assessed individually by the surgeon.
Is an abdominal binder needed after surgery?+
Use of an abdominal belt or binder may be indicated in some cases for support and comfort during initial recovery, but this guidance varies according to the surgeon's assessment and is not a universal requirement for all patients.
Can the mesh used in the repair be felt or cause discomfort?+
It is possible to notice slight firmness or discomfort in the operated area during the healing process, a sensation that tends to decrease over time; any persistent or unusual discomfort should be evaluated by the surgeon.
What care is needed for the dressing and stitches after surgery?+
It is generally recommended to keep the dressing clean and dry in the first few days, avoid excessively wetting the area before medical clearance, and watch for signs such as redness, discharge, or fever, which should be promptly reported to the medical team.
What are the main risks specific to this surgery?+
As with any surgical procedure, there are risks; in the case of epigastric hernia repair, these may include seroma (fluid buildup) or hematoma formation in the operated area, infection of the wound or mesh used, persistent pain at the site, and the possibility of hernia recurrence. The frequency of these events varies according to individual factors and should be discussed in consultation with the surgeon.
Can the hernia come back (recur) even after surgery?+
Yes: although the surgery aims to reduce this risk, no surgical technique completely eliminates the possibility of recurrence. Factors such as obesity, smoking, excessive physical exertion after surgery, and the characteristics of the patient's own tissue can influence this risk, which should be discussed individually with the surgeon.
Hospital facilities in Uberlândia, Brazil.
Hospital Mater Dei Santa Genoveva
Av. Vasconcelos Costa, 967 — Martins, Uberlândia-MG
Open in Google Maps →Content reviewed by Dr. Solon Gonçalves Souza Menezes — CRM-MG 79366, RQE 60355 (GI Surgery), RQE 44656 (General Surgery). Professor of Surgery at FAMED-UFU and Supervisor of the General Surgery Medical Residency Program at HC-UFU. ORCID. Last reviewed: September/2026.
- Douissard J, Meyer J, Dupuis A, et al. Robotic versus open primary ventral hernia repair: A randomized controlled trial (Robovent Trial). Int J Surg Protoc. 2020;21:27-31. doi:10.1016/j.isjp.2020.03.004
- Pini R, Mongelli F, Iaquinandi F, et al. Switching from robotic-assisted extended transabdominal preperitoneal (eTAPP) to totally extraperitoneal (eTEP) hernia repair for umbilical and epigastric hernias. Sci Rep. 2024;14(1):1800. doi:10.1038/s41598-024-52165-6
- Hager M, Edgerton C, Hope WW. Primary Uncomplicated Ventral Hernia Repair: Guidelines and Practice Patterns for Routine Hernia Repairs. Surg Clin North Am. 2023;103(5):901-915. doi:10.1016/j.suc.2023.04.004