Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Robot-assisted laparoscopic mesh repair of incisional hernias with exclusive intracorporeal suturing: a pilot study

  • 418 Accesses

  • 30 Citations



The da Vinci robot laparoscopic incisional hernia repair with intracorporeal suturing may offer an alternative to transabdominal sutures and tackers.


From 2003 to 2005, 11 patients (median age, 71 years; median body mass index [BMI], 28) with small and medium-sized incisional hernias (median fascial defect, 19.6 cm2) were treated with the da Vinci robot system using intracorporeal mesh fixation with interrupted sutures. This pilot study aimed to assess the feasibility and report the morbidity with special reference to postoperative pain and long-term recurrence.


The median operative time was 180 min. There was no conversion to open or standard laparoscopy and no postoperative mortality. The overall morbidity rate was 27%. One patient underwent reoperation on postoperative day 3 for peritonitis secondary to small bowel injury. The median visual analog pain score on postoperative day 1 was 3. Seven patients (63%) needed parenteral paracetamol until postoperative day 2. The median hospital stay was 3 days. During a median follow-up period of 25 months, no patient experienced recurrent hernia. One patient had a trocar-site herniation at 6 months. No patient experienced chronic suture site pain or discomfort.


This is the first report of robot-assisted laparoscopic incisional hernia with exclusive intracorporeal suturing for mesh fixation in humans. The findings show that this technique is feasible and may not be associated with chronic postoperative pain. Further evaluation is needed to assess the benefit to the patient, but this investigation may be the basis for a future, prospective, randomized study.

This is a preview of subscription content, log in to check access.


  1. 1.

    Ballantyne GH (2002) Robotic surgery, telerobotic surgery, telepresence, and telementoring: review of early clinical results. Surg Endosc 16: 1389–1402

  2. 2.

    Bower CE, Reade CC, Kirby LW, Roth JS (2004) Complications of laparoscopic incisional-ventral hernia repair: the experience of a single institution. Surg Endosc 18: 672–675

  3. 3.

    Cadiere GB, Himpens J, Germay O, Izizaw R, Degueldre M, Vandromme J, Capelluto E, Bruyns J (2001) Feasibility of robotic laparoscopic surgery: 146 cases. World J Surg 25: 1467–1477

  4. 4.

    Corcione F, Esposito C, Cuccurullo D, Settembre A, Miranda N, Amato F, Pirozzi F, Caiazzo P (2005) Advantages and limits of robot-assisted laparoscopic surgery: preliminary experience. Surg Endosc 19: 117–119

  5. 5.

    Earle D, Seymour N, Fellinger E, Perez A (2006) Laparoscopic versus open incisional hernia repair: a single-institution analysis of hospital resource utilization for 884 consecutive cases. Surg Endosc 20: 71–75

  6. 6.

    Giulianotti PC, Coratti A, Angelini M, Sbrana F, Cecconi S, Balestracci T, Caravaglios G (2003) Robotics in general surgery: personal experience in a large community hospital. Arch Surg 138: 777–784

  7. 7.

    Heniford BT, Park A, Ramshaw BJ, Voeller G (2000) Laparoscopic ventral and incisional hernia repair in 407 patients. J Am Coll Surg 190: 645–650

  8. 8.

    LeBlanc KA (2000) Current considerations in laparoscopic incisional and ventral herniorrhaphy. JSLS 4: 131–139

  9. 9.

    LeBlanc KA (2001) The critical technical aspects of laparoscopic repair of ventral and incisional hernias. Am Surg 67: 809–812

  10. 10.

    McKinlay RD, Park A (2004) Laparoscopic ventral incisional hernia repair: a more effective alternative to conventional repair of recurrent incisional hernia. J Gastrointest Surg 8: 670–674

  11. 11.

    Park A, Birch DW, Lovrics P (1998) Laparoscopic and open incisional hernia repair: a comparison study. Surgery 124: 816–822

  12. 12.

    Perrone JM, Soper NJ, Eagon JC, Klingensmith ME, Aft RL, Frisella MM, Brunt LM (2005) Perioperative outcomes and complications of laparoscopic ventral hernia repair. Surgery 138: 708–715

  13. 13.

    Robbins SB, Pofahl WE, Gonzalez RP (2001) Laparoscopic ventral hernia repair reduces wound complications. Am Surg 67: 896–900

  14. 14.

    Rudmik LR, Schieman C, Dixon E, Debru E (2006) Laparoscopic incisional hernia repair: a review of the literature. Hernia 10: 110–119

  15. 15.

    Schluender S, Conrad J, Divino CM, Gurland B (2003) Robot-assisted laparoscopic repair of ventral hernia with intracorporeal suturing. Surg Endosc 17: 1391–1395

  16. 16.

    Talamini MA, Chapman S, Horgan S, Melvin WS (2003) A prospective analysis of 211 robotic-assisted surgical procedures. Surg Endosc 17: 1521–1524

  17. 17.

    Tani KM, Neumayer L, Reda D, Kim L, Anthony T (2004) Repair of ventral incisional hernia: the design of a randomized trial to compare open and laparoscopic surgical techniques. Am J Surg 188: 22S–29S

  18. 18.

    Van’t RM, Vrijland WW, Lange JF, Hop WC, Jeekel J, Bonjer HJ (2002) Mesh repair of incisional hernia: comparison of laparoscopic and open repair. Eur J Surg 168: 684–689

Download references

Author information

Correspondence to C. Tayar.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Tayar, C., Karoui, M., Cherqui, D. et al. Robot-assisted laparoscopic mesh repair of incisional hernias with exclusive intracorporeal suturing: a pilot study. Surg Endosc 21, 1786–1789 (2007). https://doi.org/10.1007/s00464-007-9247-3

Download citation


  • Da Vinci Robot
  • Incisional hernia
  • Laparoscopy
  • Ventral hernia repair