Robot-assisted inguinal hernia repair and prostatectomy: safety and outcomes from a retrospective cohort study

Prostate cancer and inguinal hernia frequently coexist in elderly men, with 20-33% of patients undergoing radical prostatectomy also presenting with an inguinal hernia. Combining robot-assisted radical prostatectomy (RARP) with transabdominal preperitoneal (rTAPP) hernia repair offers both clinical and logistical benefits, although concerns regarding mesh-related complications remain. This retrospective cohort study analyzed 40 patients who underwent combined RARP and rTAPP hernia repair between August 2021 and September 2024. The mean operative time was 192.83 ± 32.57 min, with 54.2 ± 16.75 min dedicated to hernia repair. No mesh-related complications, including seromas or hematomas in the inguinal region, were observed. Minor complications (Clavien-Dindo ≤ 2) occurred in 25.64% of patients, with seromas (12.82%) and surgical site infections (7.69%) being the most common. The average hospital stay was 1.9 ± 0.50 days, and no hernia recurrences were noted during a mean follow-up of 16.03 ± 10.32 months. These findings support the safety and feasibility of simultaneous RARP and rTAPP hernia repair, maintaining low complication rates and eliminating the need for additional surgeries. Further multicenter studies are needed to validate these results and assess long-term outcomes.