Inguinal Repair via Robotic Assisted Technique: Literature Review

Abstract

Introduction:Inguinal hernia is one of the most frequent surgical diseases. Currently, with the advantages of minimally invasive surgery, new questions arise: what will be the best approach for correction of inguinal hernia? Is there real benefit to the robotic approach? Objective:To compile results of the published studies that used the robot-assisted technique in the repair of inguinal hernia, analyzing its limitations, complications and comparing it with those of the pre-existing techniques. Method:The review was performed from the Medline database with the following descriptors: (inguinal hernia repair OR hernioplasty OR hernia) AND (robot OR robotic OR robotic assisted) being retrieved 391 articles. After verification of the titles and abstracts, we identified eight series of cases congruent with the objectives of this review. Three reviewers participated in the extraction and selection of results. Results:Comparative studies showed an increase in surgical time in relation to the open and videolaparoscopic approach. The complications present similar rates with the other repair routes. Conclusion:This technique has been shown to be effective for the correction of inguinal hernia, but the benefits of using robotic surgery are unclear. So, there is a need for randomized studies comparing laparoscopic to robotic repair

Robotic inguinal hernia repair: systematic review and meta‐analysis

“…With a lifetime risk of nearly 25% in men and 3% in women, more than 20 million groin hernial repairs are carried out worldwide 1,2 . Traditionally, hernial repair is carried out with the open techniques with a low morbidity rate; however, with the advent of minimally invasive surgery, the procedure has been carried out utilizing laparoscopy 3,4 . Laparoscopy has the advantage of shorter recovery periods than the traditional open Lichtenstein procedure 5 .…”

“…However, with the advent of the robotic system, given an increased manoeuvrability, improved vision with 10 times magnification, three‐dimensional views, enhanced endo‐wrist dexterity and a shorter learning curve, robotic hernia repair is becoming more popular and being utilized by skilled surgeons 3,4,6,7 . Worldwide, there has been an exponential increase in the use of the robot through the surgical specialties, with nearly a 175% increase over a 5‐year period and 625% increase in the USA alone 8,9 …”

“…The first robotic series published was described in 2015 in France; however since then, the number of centres have risen significantly reporting their outcomes 12 . Furthermore, there have been a number of studies that have looked at various aspects of the robotic technique, in addition to four review articles 3,4,6,13 . However, these have only included less than half of the current published literature describing robotic hernial repairs, in addition to missing out published literature on the subject matter.…”

Primary Abandon-of-the-Sac (Pas) Technique: Preliminary Results of a Novel Minimally Invasive Approach for Inguinoscrotal Hernia Repair

“…One of the biggest concerns over performing robotic-assisted surgery is cost, however a recent report regarding robotic and laparoscopic procedures for inguinal hernia repair shows no significant difference. The robotic TAPP inguinal hernia repair had longer operative times but patients spent a shorter amount of time in recovery and noted less pain than patients who had laparoscopic TAPP inguinal hernia repair 19 , 16 . Even single port inguinal hernia procedures have also been described in the robotic platform 5 .…”

Robotic Gastrectomy: Technique Standardization

“…Robotic access has the advantages of 3-D view, more degrees of movement and better ergonomics when compared to laparoscopy 2 , 4 , 14 . This translates in lesser blood loss and arguably in quicker and less painful recovery 5 .…”