Eli Kakiashvili1, Maxim Bez2, Ibrahim Abu Shakra3, Samer Ganam4, Amitai Bickel5, Fahed Merei4, Assi Drobot4, Grigori Bogouslavski4, Walid Kassis4, Kamal Khatib4, Mahran Badran4, Yoram Kluger6, Ronit Almog7. 1. Department of Surgery A, Galilee Medical Center, Nahariya, Israel; Faculty of Medicine in the Galilee, Bar Ilan University, Safed, Israel. Electronic address: elik@gmc.gov.il. 2. Medical Corps, Israel Defense Forces, Ramat Gan, Israel. 3. Department of Surgery A, Galilee Medical Center, Nahariya, Israel. Electronic address: ibra89him.abushakra@gmail.com. 4. Department of Surgery A, Galilee Medical Center, Nahariya, Israel. 5. Department of Surgery A, Galilee Medical Center, Nahariya, Israel; Faculty of Medicine in the Galilee, Bar Ilan University, Safed, Israel. 6. Department of General Surgery, Rambam Medical Center, Haifa, Israel. 7. Director of Epidemiology Unit, Rambam Medical Center, Haifa, Israel.
Abstract
OBJECTIVE: We compared outcomes of elective inguinal hernia repair performed at one institution by three approaches: robotic-assistance, laparoscopic, and open. METHODS: Characteristics of the patients, the hernia and the procedures performed during 2014-2016 were accessed from patient electronic medical files of 137 elective inguinal hernia repairs. 24 surgeries were robotic-assisted, 16 laparoscopic and 97 open repairs. RESULTS: Distributions of age, sex and BMI did not differ between the groups. Bilateral repair was more common in the robotic (70.8%) than the laparoscopic (50.0%) and open groups (12.4%) (p < 0.001). Direct hernias were more common in the open (45.4%) than the robotic (20.8%) and laparoscopic (12.5%) groups (p < 0.001). Only 3 hernias were inguinoscrotal, all in the robotic group. The median operation times were 44.0, 79.0 and 92.5 min for the open, laparoscopic and robotic methods, respectively (p < 0.001). Among the unilateral repairs, the median operative times were the same for the robotic and laparoscopic procedures, 73 min, and less for the open procedures, 40 min. The proportion of patients hospitalized for 2-3 days was higher for open repair (13.4% vs. 6.2% and 0% for laparoscopic and robotic), but this difference was not statistically significant. The median maximal postoperative pain according to a 0-10-point visual analogue score was 5.0, 2.0 and 0 for open, laparoscopic and robotic procedures, respectively (p < 0.001). CONCLUSIONS: This report demonstrated the safety and feasibility of robotic-assisted inguinal hernia repair.
OBJECTIVE: We compared outcomes of elective inguinal hernia repair performed at one institution by three approaches: robotic-assistance, laparoscopic, and open. METHODS: Characteristics of the patients, the hernia and the procedures performed during 2014-2016 were accessed from patient electronic medical files of 137 elective inguinal hernia repairs. 24 surgeries were robotic-assisted, 16 laparoscopic and 97 open repairs. RESULTS: Distributions of age, sex and BMI did not differ between the groups. Bilateral repair was more common in the robotic (70.8%) than the laparoscopic (50.0%) and open groups (12.4%) (p < 0.001). Direct hernias were more common in the open (45.4%) than the robotic (20.8%) and laparoscopic (12.5%) groups (p < 0.001). Only 3 hernias were inguinoscrotal, all in the robotic group. The median operation times were 44.0, 79.0 and 92.5 min for the open, laparoscopic and robotic methods, respectively (p < 0.001). Among the unilateral repairs, the median operative times were the same for the robotic and laparoscopic procedures, 73 min, and less for the open procedures, 40 min. The proportion of patients hospitalized for 2-3 days was higher for open repair (13.4% vs. 6.2% and 0% for laparoscopic and robotic), but this difference was not statistically significant. The median maximal postoperative pain according to a 0-10-point visual analogue score was 5.0, 2.0 and 0 for open, laparoscopic and robotic procedures, respectively (p < 0.001). CONCLUSIONS: This report demonstrated the safety and feasibility of robotic-assisted inguinal hernia repair.