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Case Report: Robotic-Assisted Minimally Invasive Repair of a Direct Sliding Left Inguinal Hernia Containing Bladder
Anish M Varghese1, Michael R Zemaitis2, James Giannone2
1Medicine, St. George's University School of Medicine, St. George, GRD.
Cureus
|March 28, 2024
Summary
Direct sliding inguinal hernias, rare hernias involving organs like the bladder, can be complex to repair. This case explores a hybrid robotic-assisted approach for a challenging direct sliding inguinal hernia.
Area of Science:
- General Surgery
- Minimally Invasive Surgery
- Urology
Background:
- Direct sliding inguinal hernias are rare (2-5% incidence) and involve adjacent organs like the bladder or colon.
- These hernias result from lower abdominal wall weakness, often due to aging.
- Laparoscopic repair is infrequently reported, and hybrid approaches remain underexplored.
Observation:
- An 85-year-old male presented with left groin pain due to a direct sliding inguinal hernia involving the bladder wall.
- Initial robotic-assisted minimally invasive surgery was converted to an open approach due to extensive bladder involvement.
- The robot was reintroduced for mesh placement after open reduction.
Findings:
- Successful repair of a complex direct sliding inguinal hernia.
- Demonstration of a hybrid robotic-assisted/open surgical technique for challenging cases.
- Patient experienced mild post-operative pain and uneventful recovery.
Implications:
- This case highlights the feasibility of a hybrid approach in managing complex direct sliding inguinal hernias.
- Suggests potential benefits of combining robotic and open techniques for improved outcomes.
- Contributes to the limited literature on minimally invasive repair of these rare hernias.
