Robot-assisted laparoscopic total extraperitoneal hernia repair during prostatectomy: technique and initial...

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Robot-assisted Endoscopic Extraperitoneal Radical Prostatectomy (R-EERPE) is an established procedure.
• Concurrent inguinal hernia repair during R-EERPE presents unique surgical challenges.
• Evaluating the integration of hernia repair into R-EERPE is crucial for patient management.

Purpose of the Study:

• To detail the technique of Total Extraperitoneal (TEP) inguinal hernia repair during R-EERPE.
• To assess the initial outcomes and feasibility of this combined approach.
• To establish the safety and efficacy of robot-assisted TEP in this context.

Main Methods:

• A cohort of 12 patients undergoing inguinal hernia repair during 120 R-EERPE procedures were analyzed.
• The hernia repair utilized the Total Extraperitoneal Patch (TEP) technique.
• Data collected included operative time, blood loss, and postoperative complications.

Main Results:

• Robot-assisted TEP facilitated simpler sac dissection and mesh placement due to enhanced 3-D vision and instrument dexterity.
• The combined procedure added a median of 12 minutes to the operative time.
• No postoperative complications or hernia recurrences were observed at 12 months.

Conclusions:

• Robot-assisted Total Extraperitoneal inguinal hernia repair is a feasible and safe adjunct to R-EERPE.
• The enhanced visualization and control offered by robotics improve the TEP procedure.
• This combined approach should be considered for patients requiring both R-EERPE and inguinal hernia repair.