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First Results of Pediatric Robotic Inguinal Hernia Repair with the Senhance® Surgical System: A Matched Cohort Study
Roxanne Eurlings1,2, Rianne E M Killaars1,2, Hamit Cakir1,3
1Department of Pediatric Surgery, MosaKids Children's Hospital, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.
Insights
Robot-assisted inguinal hernia repair (RIHR) using the Senhance Surgical System (SSS) is safe and feasible in children. Further research is needed to confirm efficacy in larger pediatric populations.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Robotic Surgery
Background:
- Inguinal hernia repair (IHR) is a common pediatric surgical procedure.
- The application and assessment of robotic surgery in pediatric patients are limited.
- This study introduces the first global report on IHR in children using the Senhance Surgical System (SSS).
Purpose of the Study:
- To assess the safety and feasibility of robot-assisted IHR (RIHR) in children.
- To compare RIHR using the SSS with conventional laparoscopic IHR (LIHR).
Main Methods:
- A matched cohort pilot study involving 26 pediatric patients (3 months to 8 years) undergoing RIHR with SSS (31 hernias).
- Patients were matched by gender, age, and hernia type (unilateral/bilateral) to 26 patients who underwent LIHR (32 hernias).
- Data collected on anesthesia time, surgical time, outcomes, and complications.
Main Results:
- A significant difference in total anesthesia time was observed, attributed to robot docking procedures in the RIHR group.
- No significant difference in surgical time was found between RIHR and LIHR.
- Both groups showed similar recurrence rates (3.2%), and one patient in the LIHR group experienced a hemorrhage requiring no intervention.
Conclusions:
- Robot-assisted inguinal hernia repair using the Senhance Surgical System is safe and feasible in pediatric patients.
- Further investigation with larger sample sizes and long-term follow-up is required.
- System improvements for very young children are recommended to enhance efficacy.
Introduction:
Inguinal hernia repair (IHR) is one of the most common procedures in pediatric surgery. In children, the application of robotic surgery is limited, meaning safety and efficacy is still to be assessed. This report is the first one worldwide that describes inguinal hernia repair in children using the Senhance® Surgical System (SSS®). The aim of this matched cohort study is to assess safety and feasibility of robot-assisted IHR (RIHR) in children, compared to conventional laparoscopic IHR (LIHR).
Patients And Methods:
This pilot study included 26 consecutive patients between 3 months and 8 years old who underwent RIHR (31 IH's) with the SSS® between 2020 and 2024. These cases were matched based on gender, age, and unilateral or bilateral IH, with 26 patients (32 IH's) who underwent conventional LIHR.
Results:
There was a significant difference in total anesthesia time, which is most likely due to the extra time needed to dock the robot in the RIHR cases. No significant difference was seen in surgical time. One recurrence (3.2%) was diagnosed in both groups. One patient in the LIHR group was readmitted on the day of discharge due to a hemorrhage. No intervention was necessary, and the patient was discharged 1 day later.
Discussion:
In this pilot study, the use of the robotic system was safe and feasible. More experience, further improvement of the system for use in very small children, and investigation in a larger sample size with long-term follow-up is necessary to evaluate efficacy.
