Senhance versus da Vinci robotic inguinal hernia repair: a multi-center propensity-weighted study

Inguinal hernia repair is a common surgical procedure, with robotic-assisted surgery increasingly adopted as a minimally invasive approach. While the da Vinci Surgical System offers advantages, its high cost motivates the search for more economical alternatives. The Senhance surgical system, a laparoscopy-based platform with reusable instruments, presents a potential cost-effective option. This study aims to compare the clinical outcomes and preliminary costs of Senhance and da Vinci robotic platforms in inguinal hernia repair.

This retrospective, observational study analyzed data from eight teaching hospitals using either the Senhance (n = 167) or da Vinci (n = 278) system for robotic inguinal hernioplasty (January 2019-January 2024). Propensity score overlap weighting was used to balance baseline characteristics between groups. Primary outcomes were operative time (ORTIME), console time (CONTIME), and total length of hospital stay (LOS). Secondary outcomes included postoperative length of stay (Post LOS), intraoperative and postoperative complications, and recurrence rate.

After overlap weighting, the Senhance group demonstrated significantly shorter operative time (108.42 ± 41.32 vs. 150.50 ± 61.51 min, p < 0.001) and console time (40.95 ± 44.6 vs. 65.56 ± 63.36 min, p = 0.005) compared to the da Vinci group. There were no significant differences in intraoperative or postoperative complications, or recurrence rates between the two groups. Postoperative length of stay was also significantly shorter in the Senhance group (2.24 ± 0.69 vs. 2.63 ± 1.09 days, p = 0.007). Preliminary cost analysis showed lower out-of-pocket expenses for patients undergoing Senhance robotic hernioplasty.

The Senhance robotic system was associated with reduced operative duration and postoperative hospital stay compared to the da Vinci system in inguinal hernia repair, without increasing complications or recurrence. These findings suggested that the Senhance system may be a cost-effective alternative to the da Vinci platform for robotic inguinal hernia repair. Further studies are warranted to investigate long-term outcomes and comprehensive cost-effectiveness.