David S Edelman, MD. Baptist Health, Doctors Hospital
Introduction: Robotic surgery adds high definition visualization and articulating instruments which enhances dexterity that makes laparoscopic hernia repair very refined. The Urologic literature reports 25% of patients undergoing robotic radical prostectomy have inguinal hernias. A series of robotic, laparoscopic, inguinal hernia repairs by a single surgeon with an extensive laparoscopic hernia experience at a single institution was undertaken to determine the role of robotic laparoscopic inguinal hernia repair in minimally invasive surgery.
Methods: Five hundred seventy-seven (577) laparoscopic inguinal hernia operations were performed from April 2012 through May 2016. There were 172 patients having 220 robotic TAPP (trans-abdominal pre-peritoneal) procedures done during that time. Hospital records and follow up care were prospectively reviewed and data collected for age, sex, American Society of Anesthesia (ASA) class and operative time. Follow up was done at 2 weeks, 8 weeks and 16 weeks following surgery. All patients consented for study.
Results: Ninety percent (90%) of the patients were male. Age averaged 56.1 years with a range of 21-85 years. ASA averaged 2.01 with co-morbidities of hypertension, hypercholesterolemia and GERD being the most common. BMI was between 19-31.6, averaging 27.01. Thirty-two patients (18.6%) had an umbilical hernia repair done concomitantly. OR time ranged from 25-140 minutes with an average of 63.1 minutes decreasing as experience increased. One patient with a large, left scrotal hernia was converted to open, two patient developed perforated sigmoid diverticulitis 7 days post op and case #5 recurred indirectly after a direct hernia repair. Four patients required prolonged post-operative foley catheterization.
Conclusion: Robotic inguinal hernia repair is safe and effective. OR time was longer than standard laparoscopic herniorraphy but decreased with experience. In addition, robotic prostatectomy patients have a high incidence of inguinal hernias. The newly released robotic single port platform may have use in inguinal patients with umbilical hernias, 19%, and this will need to be studied further.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 77300
Program Number: P694
Presentation Session: Poster (Non CME)
Presentation Type: Poster
