Our Summary

This research paper compares two methods of repairing inguinal hernias (a type of hernia in the groin area): the standard laparoscopic procedure (LHR) and the robotic approach (RHR). The researchers looked at studies published between 2010 and 2021, and found 9 articles that were suitable for their analysis. These articles covered a total of 64,426 patients, of which 7,589 underwent the robotic procedure.

The study found that patients with a higher risk score (ASA > 2) were more likely to receive the robotic procedure (12.4% vs 8.6%). The laparoscopic procedure was more commonly used for unilateral hernia repair (when the hernia is on one side only), while the robotic procedure was more likely to be used for bilateral repair (when hernias are on both sides).

The robotic procedure generally took longer than the laparoscopic one (160 minutes vs 90 minutes on average). However, when the researchers looked at unilateral repairs only, the time difference was less (88 minutes for RHR vs 68 minutes for LHR). There was no difference in surgery time for bilateral repairs. There were no cases where the robotic procedure had to be converted to open surgery.

In terms of safety and post-surgery outcomes, the two methods were similar. There was no significant difference in the rate of chronic pain or other complications after surgery. However, the robotic procedure was more expensive, with an average cost difference of $3270.

In simple terms, this study suggests that both laparoscopic and robotic procedures are safe and effective for repairing inguinal hernias. The robotic procedure may take longer and cost more, especially for unilateral repairs. However, it is also more likely to be used for higher-risk patients and for bilateral repairs.

FAQs

  1. What is the difference in operative time between the robotic and laparoscopic approach for inguinal hernia repair?
  2. Is there a significant difference in safety parameters and postoperative outcomes between laparoscopic and robotic inguinal hernia repair?
  3. How do the costs of laparoscopic and robotic inguinal hernia repair compare?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic hernia repair is to follow post-operative instructions carefully, including avoiding heavy lifting and strenuous activities for a certain period of time to allow for proper healing. It is also important to attend follow-up appointments with your surgeon to ensure that the hernia repair is successful and to address any concerns or complications that may arise.

Suitable For

Patients who are typically recommended for laparoscopic hernia repair include those with inguinal hernias that are suitable for minimally invasive surgery, such as uncomplicated inguinal hernias in adults. Patients who are generally healthy and able to tolerate general anesthesia are also good candidates for laparoscopic hernia repair. Additionally, patients who have previously had successful laparoscopic surgeries or who have a preference for minimally invasive procedures may also be recommended for laparoscopic hernia repair.

Timeline

  1. Preoperative evaluation: The patient undergoes a physical examination, medical history review, and may undergo imaging tests such as ultrasound or CT scan to confirm the presence and location of the hernia.

  2. Consultation with surgeon: The patient meets with a surgeon to discuss treatment options, risks, benefits, and recovery process. The decision to undergo laparoscopic hernia repair is made.

  3. Day of surgery: The patient arrives at the hospital or surgical center, undergoes preoperative preparations, and is taken to the operating room for the laparoscopic hernia repair procedure.

  4. Laparoscopic hernia repair: The surgeon makes small incisions in the abdomen, inserts a laparoscope and surgical instruments to repair the hernia using mesh. The procedure typically takes around 90 minutes to complete.

  5. Recovery: The patient is monitored in the recovery room before being discharged home the same day or after a short overnight stay. They are advised on postoperative care, pain management, and activity restrictions.

  6. Follow-up appointments: The patient may have follow-up appointments with the surgeon to monitor healing, address any concerns, and discuss returning to normal activities.

  7. Long-term outcomes: The patient experiences a quicker recovery, less pain, and a lower risk of complications compared to traditional open hernia repair. They can return to work and normal activities sooner, with a reduced risk of hernia recurrence.

Overall, laparoscopic hernia repair offers a minimally invasive approach with shorter recovery time, less pain, and comparable long-term outcomes to open surgery.

What to Ask Your Doctor

  1. What are the benefits of laparoscopic hernia repair compared to traditional open surgery?
  2. How experienced are you in performing laparoscopic hernia repair?
  3. What are the potential risks and complications associated with laparoscopic hernia repair?
  4. How long is the recovery time after laparoscopic hernia repair?
  5. Will I need any special follow-up care or physical therapy after the procedure?
  6. How does the cost of laparoscopic hernia repair compare to other treatment options?
  7. Are there any specific criteria or conditions that make me a better candidate for laparoscopic hernia repair?
  8. What type of anesthesia will be used during the procedure?
  9. How many laparoscopic hernia repairs have you performed, and what is your success rate?
  10. Will I need any special equipment or modifications to my lifestyle after the procedure?

Reference

Authors: Solaini L, Cavaliere D, Avanzolini A, Rocco G, Ercolani G. Journal: J Robot Surg. 2022 Aug;16(4):775-781. doi: 10.1007/s11701-021-01312-6. Epub 2021 Oct 5. PMID: 34609697