Robot-assisted repair of complicated inguinal hernia: Advantages in comparison with conventional repair

Abstract

The adoption rate of robot-assisted surgery has skyrocketed in recent years, despite limited evidence, an unclear clinical benefit, and an increase in cost. The laparoscopic approach to inguinal hernia repair by either transabdominal or extraperitoneal approach has gradually gained traction owing to distinct advantages over traditional open repairs. Although robotic inguinal hernia repair has been established as a safe alternative to conventional laparoscopy, as of yet no superiority has been proven. We aim to give an overview of certain clinical situations, in which the robot might be advantageous. Specifically, we discuss inguinoscrotal hernia repair, inguinal hernia repair after prostatectomy, and mesh explantation. In our opinion, robotic systems are an invaluable tool in the case of mesh resection or recurrence after previous anterior and posterior repairs. With the increased expansion of the surgical tools and techniques to repair abdominal wall problems, a definitive and clear rule as to which cases should be handled robotically and which should not will be difficult and probably unattainable. We are very much proponents of a tailored approach, where every individual case deserves its surgical plan, bearing in mind all aspects of a patient, with the aim of the best surgical outcome.