Marissa C Maas, Evan T Alicuben, MD, Caitlin C Houghton, MD, Kamran Samakar, MD, Kulmeet K Sandhu, MD, Adrian Dobrowolsky, MD, Nikolai Bildzukewicz, MD. Keck School of Medicine of USC
INTRODUCTION: Robotic technology provides another tool in the arsenal of the minimally-invasive surgeon with emerging uses for general surgical procedures. Given the limited working space in the pelvis, the increased dexterity offered by the robot may prove beneficial in the repair of inguinal hernias. Currently, there are only a few studies examining the use of robotic technology for inguinal hernia repair. Our aim was to detail our experience with robotic inguinal hernia repair at an academic institution.
METHODS AND PROCEDURES: We performed a retrospective chart review on all patients who had undergone robotic inguinal hernia repair from March 2015 to April 2018. Preoperative demographics, operative characteristics, and postoperative outcomes were analyzed using RStudio software. The primary outcome was hernia recurrence.
RESULTS: There were 43 patients, 40 of which were male. The patients had a mean age of 56 years (range 18-85 years). Thirteen of the patients had bilateral hernias. The mean patient BMI was 26.4 (range 17.5-42.3). All operations were performed transabdominally and all but one included fixation of synthetic polypropylene mesh. Regarding mesh attachment, 23 patients had suture only, 14 had tacks only, 1 had a combination of suture and tacks, 2 had suture and glue, 2 had tacks and glue. The mean patient in-room time was 4.0 hours, mean operative time was 2.9 hours, and the mean robot docked time was 2.0 hours. Thirty-two patients were discharged on the day of surgery. One patient was kept overnight for treatment of urinary retention. The other 10 patients were kept for one or two nights for observation. There was one bladder injury discovered intraoperatively, which was primarily repaired. Post-operatively, none of the patients had wound infections, 11 developed seromas, and one patient had a groin hematoma. At a median follow up of 37.5 days, there was one recurrence. This was discovered incidentally during a urological procedure and was repaired.
CONCLUSIONS: Robotic surgery in inguinal repair is safe and effective and should be considered a viable alternative to laparoscopic and open repairs. Longer term studies will further define the role of this technology.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94880
Program Number: P545
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster