Feasibility of robotic-assisted minimally invasive inguinal hernia repair in patients with urologic considerations inclu
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ORIGINAL ARTICLE
Feasibility of robotic‑assisted minimally invasive inguinal hernia repair in patients with urologic considerations including artificial urinary sphincters and bladder herniation Caleb Lade1 · Samara Lewis1 · Kiran Venincasa1 · Allison Harmon1 · Preston Choi1 · Benjamin Lee1 · Alexander Raines1 Received: 30 September 2020 / Accepted: 18 October 2020 © Springer-Verlag London Ltd., part of Springer Nature 2020
Abstract Robotic surgical technology has the potential to broaden the applicability of minimally invasive approaches into more complex, technically challenging inguinal hernia repairs. A unique patient population requiring inguinal hernia repair are those patients who either have artificial urinary sphincters (AUS) or inguinal bladder herniation (IBH). Traditionally, these patients have not been considered candidates for minimally invasive inguinal hernia repairs. Through this retrospective series, we aim to contribute to the growing body of literature on robotic-assisted inguinal hernia repair (RIHR) by describing our experience with RIHR in this patient subset. We performed a retrospective chart review of RIHR cases performed from June 2017 to April 2019 by a single surgeon at our university-affiliated community hospital. Charts were reviewed for preoperative considerations, operative complications, and postoperative outcomes. A total of three patients with an AUS and six patients with IBH were included, all of whom were male. All the patients received transabdominal preperitoneal (TAPP) approaches, and all received placement of mesh. There were no intraoperative complications and no conversions to open surgery. Postoperatively, one patient with IBH had persistent surgical site pain that resolved after 3 weeks and one patient, also with IBH, had a surgical site seroma that resolved without further intervention. Mean follow-up time was 10.71 and 12.13 months for patients with AUS and IBH, respectively. No patients reported hernia recurrence during this time. This review suggests that the use of robotic assistance for laparoscopic inguinal hernia repair is safe and effective and may provide additional benefits for patients with concurrent urological considerations such as AUS and IBH. Keywords Robot-assisted laparoscopic inguinal hernia repair · RIHR · Transabdominal preperitoneal · TAPP · Artificial urinary sphincter · AUS · Inguinal bladder herniation · IBH · Minimally invasive surgery · Inguinal hernia repair
Introduction Age represents a common risk factor for both inguinal hernia and many urological conditions. Consequently, many patients presenting for inguinal hernia repair also have concurrent urological considerations, which can complicate hernia treatment [1]. While traditional teachings cautioned that prior pelvic surgery or other urologic considerations were contraindications to minimally invasive hernia repairs, studies have since shown that minimally invasive * Caleb Lade Caleb‑[email protected] 1
College of Medicine (Department of Surgery), The University of Oklahoma, Okla
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