Minimally Invasive Hernia Repair in Robot-assisted Radical Prostatectomy

Inguinal hernia is a recognized complication of radical prostatectomy. Previous hernia repair, wound infection, midline incision, low BMI, and preexisting or subclinical hernia contribute to the risk of inguinal hernia following radical prostatectomy. Concomitant hernia repair at the time of pelvic surgery has risks and benefits. Repair during surgery prevents future hernia-related complications and saves the need for an additional procedure. However, hernia repair at the time of radical prostatectomy includes the risk of mesh infection, post-operative pain, adhesions, lack of experience, and overall minimal risk with watchful waiting. The robotic transperitoneal approach is the most commonly used technique for concomitant inguinal hernia repair with a modest addition to operative time and minimal postoperative complications. Recurrence rates following concomitant hernia repair during pelvic surgery are low.