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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
de Goede B, Timmermans L, van Kempen BJ, van Rooij FJ, Kazemier G, Lange JF, Hofman A, Jeekel J (2015) Risk factors for inguinal hernia in middle-aged and elderly men: results from the Rotterdam Study. Surgery 157(3):540–546. https://doi.org/10.1016/j.surg.2014.09.029
Winslow ER, Quasebarth M, Brunt LM (2004) Perioperative outcomes and complications of open vs laparoscopic extraperitoneal inguinal hernia repair in a mature surgical practice. Surg Endosc 18(2):221–227. https://doi.org/10.1007/s00464-003-8934-y
Wauschkuhn CA, Schwarz J, Bittner R (2009) Laparoscopic transperitoneal inguinal hernia repair (TAPP) after radical prostatectomy: is it safe? Results of prospectively collected data of more than 200 cases. Surg Endosc 23(5):973–977. https://doi.org/10.1007/s00464-008-0291-4
Stoker DL, Spiegelhalter DJ, Singh R, Wellwood JM (1994) Laparoscopic versus open inguinal hernia repair: randomised prospective trial. Lancet 343(8908):1243–1245. https://doi.org/10.1016/s0140-6736(94)92148-2
Iraniha A, Peloquin J (2018) Long-term quality of life and outcomes following robotic assisted TAPP inguinal hernia repair. J Robot Surg 12(2):261–269. https://doi.org/10.1007/s11701-017-0727-8
Wellwood J, Sculpher MJ, Stoker D, Nicholls GJ, Geddes C, Whitehead A, Singh R, Spiegelhalter D (1998) Randomised controlled trial of laparoscopic versus open mesh repair for inguinal hernia: outcome and cost. BMJ 317(7151):103–110. https://doi.org/10.1136/bmj.317.7151.103
Eklund A, Montgomery A, Bergkvist L, Rudberg C, Swedish Multicentre Trial of Inguinal Hernia Repair by Laparoscopy study g (2010) Chronic pain 5 years after randomized comparison of laparoscopic and Lichtenstein inguinal hernia repair. Br J Surg 97(4):600–608. https://doi.org/10.1002/bjs.6904
Dickens EO, Kolachalam R, Gonzalez A, Richardson C, D’Amico L, Rabaza J, Gamagami R (2018) Does robotic-assisted transabdominal preperitoneal (R-TAPP) hernia repair facilitate contralateral investigation and repair without compromising patient morbidity? J Robot Surg 12(4):713–718. https://doi.org/10.1007/s11701-018-0815-4
Dastur JK, Entikabi F, Parker MC (2006) Repair of incidental contralateral defects found during laparoscopic transabdominal preperitoneal (TAPP) repair of unilateral groin hernias. Surg Endosc 20(12):1924. https://doi.org/10.1007/s00464-005-0386-0
Novitsky YW, Czerniach DR, Kercher KW, Kaban GK, Gallagher KA, Kelly JJ, Heniford BT, Litwin DE (2007) Advantages of laparoscopic transabdominal preperitoneal herniorrhaphy in the evaluation and management of inguinal hernias. Am J Surg 193(4):466–470. https://doi.org/10.1016/j.amjsurg.2006.10.015
Escobar Dominguez JE, Ramos MG, Seetharamaiah R, Donkor C, Rabaza J, Gonzalez A (2016) Feasibility of robotic inguinal hernia repair, a single-institution experience. Surg Endosc 30(9):4042–4048. https://doi.org/10.1007/s00464-015-4717-5
Carson CC (2020) Artificial urinary sphincter: current status and future directions. Asian J Androl 22(2):154–157. https://doi.org/10.4103/aja.aja_5_20
Leroy J, Saussine, C., Marescaux, J. (2013) TAPP laparoscopic repair of right inguinal hernia after artificial sphincter placement for post-prostatectomy urinary incontince. WebSurg,
Gomella LG, Spires SM, Burton JM, Ram MD, Flanigan RC (1985) The surgical implications of herniation of the urinary bladder. Arch Surg 120(8):964–967. https://doi.org/10.1001/archsurg.1985.01390320084018
Moufid K, Touiti D, Mohamed L (2013) Inguinal bladder hernia: four case analyses. Rev Urol 15(1):32–36
Catalano O (1997) US evaluation of inguinoscrotal bladder hernias: report of three cases. Clin Imaging 21(2):126–128. https://doi.org/10.1016/s0899-7071(96)00018-6
Branchu B, Renard Y, Larre S, Leon P (2018) Diagnosis and treatment of inguinal hernia of the bladder: a systematic review of the past 10 years. Turk J Urol 44(5):384–388. https://doi.org/10.5152/tud.2018.46417
AlMohaya N, Alabdrabalameer MNE, AlAnazi K, AlMuhsin AM, Eltomy H (2019) Bilateral inguinal bladder hernia following unilateral transabdominal preperitoneal repair. A case report and review of the literature. Ann Med Surg (Lond) 46:23–26. https://doi.org/10.1016/j.amsu.2019.08.005
Cetrulo LN, Harmon J, Ortiz J, Canter D, Joshi AR (2015) Case report of a robotic-assisted laparoscopic repair of a giant incarcerated recurrent inguinal hernia containing bladder and ureters. Int J Med Robot 11(1):15–17. https://doi.org/10.1002/rcs.1597
Sung ER, Park SY, Ham WS, Jeong W, Lee WJ, Rha KH (2008) Robotic repair of scrotal bladder hernia during robotic prostatectomy. J Robot Surg 2(3):209–211. https://doi.org/10.1007/s11701-008-0108-4
Funding
No funding was received to assist with the preparation of this manuscript.
Author information
Authors and Affiliations
Contributions
AR conceived this work; AH, PC, and BL contributed to the acquisition of data; CL, SL, KV and AR analyzed and interpreted the data; CL wrote the manuscript; SL and AR provided critical revision. All the authors were involved in the review and final approval of the manuscript.
Corresponding author
Ethics declarations
Conflict of interest
The authors have no relevant financial or non-financial interests to disclose.
Ethical approval
This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Human Investigation Committee (IRB) of University of Oklahoma Health Sciences Center approved this study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Lade, C., Lewis, S., Venincasa, K. et al. Feasibility of robotic-assisted minimally invasive inguinal hernia repair in patients with urologic considerations including artificial urinary sphincters and bladder herniation. J Robotic Surg 15, 695–699 (2021). https://doi.org/10.1007/s11701-020-01163-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11701-020-01163-7