The following is a summary of “Short-term outcomes of robotic inguinal hernia repair during robotic prostatectomy – An analysis of the Abdominal Core Health Quality Collaborative,” published in the FEBRUARY 2023 issue of Surgery by Figueiredo, et al.

Concomitant robotic-assisted laparoscopic prostatectomy (RALP) and robotic inguinal hernia repair (RIHR) have been reported, but their safety was uncertain. The risk of mesh-related complications in the setting of a fresh vesicourethral anastomosis has led some surgeons to avoid performing both procedures together. For a study, researchers sought to compare the 30-day outcomes of patients undergoing RALP+RIHR with those undergoing RIHR alone.

They identified patients who underwent concomitant RALP and RIHR with 30-day follow-up available using the Abdominal Core Health Quality Collaborative. A cohort of patients undergoing RIHR alone was matched with the RALP+RIHR group using a propensity score algorithm based on confounders, including body mass index, age, ASA class, smoking, hernia size, recurrent status, and prior pelvic operation. They compared the groups for 30-day rates of surgical site infection (SSI), surgical site occurrences (SSO), surgical site occurrences requiring operative intervention (SSOPI), and hernia recurrence.

A total of 24 patients underwent RALP + RIHR and were matched with 72 patients who underwent RIHR alone (3:1). The median age was 64 years, 33% were obese, and 17% were smokers. No significant differences were found in 30-day rates of overall complications (21% RALP + RIHR vs 15% RIHR, P= 0.53) and surgical site occurrences (12% RALP + RIHR vs. 11% RIHR, P = 0.85). No RALP + RIHR group patient had a 30-day SSI, SSOPI or early recurrence.

The study suggested that RALP+RIHR did not increase the rates of wound complications, overall complications, or early recurrence compared to RIHR alone. However, the study had a small sample size, and larger prospective controlled studies were needed to confirm the findings.

Reference: https://www.americanjournalofsurgery.com/article/S0002-9610(22)00554-2/fulltext