Introduction
Robotic surgery continues to expand and evolve within day case and benign general surgery. Having established a robotic benign UGI service with over 500 cases performed, our unit reviewed our experience of the first 100 robotic inguinal hernia repairs (RIHR). We present a comparative analysis of RIHR versus conventional laparoscopic (LIHR) and open inguinal hernia repair (OIHR), with a focus on peri-operative efficiency and day case feasibility.
Methods
A retrospective cohort study was conducted, identifying all elective inguinal hernia repairs performed between 10/02/2022 and 05/09/2024. A total of 1,571 cases were included: 100 RIHR, 830 LIHR, and 641 OIHR. Variables analysed included total theatre time (knife-to-skin to patient out of theatre), same-day discharge rates and 30 day outcomes including early recurrence, re-presentation rates and complications.
Results
Mean operative times were comparable across all three groups (RIHR 41.37 ± 149 min; LIHR 40.54 ± 70 min; OIHR 51.04 ± 55 min; p=0.00006579). Day case rates were high and statistically equivalent (RIHR 91%; LIHR 98%; OIHR 90%; p=0.42).
There were no conversions or intra-operative complications noted in the RIHR group. 30 day outcomes including re-presentation(RIHR 8%; LIHR 6.8%; OIHR 4.4%), re-operation (RIHR 0%, LIHR 0%, OIHR 0%) and recurrence (RIHR 0%, LIHR 0%, OIHR 2.1%) were all similar.
Conclusions
RIHR demonstrates equivalent operative efficiency and day case suitability compared to established techniques. These findings support the integration of RIHR into day case hernia pathways. Further evaluation is required to assess long-term outcomes, recurrence rates, and cost-effectiveness.
Authors
Stuart Cowie
Northumbria Healthcare NHS foundation trust, Newcastle, United Kingdom
Olivia Kent
Northumbria Healthcare NHS foundation trust, Newcastle, United Kingdom
Liam Horgan
Northumbria Healthcare NHS foundation trust, Newcastle, United Kingdom