First Report of Single-Surgeon Single-Incision Laparoscopic Percutaneous Extraperitoneal Closure Using the Senhance...

Single-incision laparoscopic percutaneous extraperitoneal closure (SILPEC) is used for pediatric inguinal hernia repair in several institutions. However, SILPEC requires at least two operators. We report the first SILPEC performed by a single surgeon using the Senhance robotic system for pediatric patients. The Senhance, which features reusable 3- to 5-mm instruments and tremor filtering, allows both eye-tracked and manually adjustable camera control via a standalone robotic arm, resulting in stable, assistant-free visualization while preserving the small port philosophy. Two pediatric patients with inguinal hernia underwent SILPEC. The laparoscope was mounted on one robotic arm, and a 3-mm curved grasper was manipulated manually through the same incision. Operative times were 71 and 77 min, without blood loss, conversions, or perioperative complications. Both patients remained recurrence-free. This report demonstrates the feasibility, safety, procedural efficiency, and potential cost-effectiveness of single-surgeon robotic assisted SILPEC, thus offering a pragmatic solution for understaffed pediatric surgical units.