Robotic Inguinal Hernia: The Why and the Hows

  • Gregory J. ManciniEmail author
  • Dennis R. Van Dorp


Robotic inguinal hernia is a controversial topic. The use of a robotic platform to perform a minimally invasive, preperitoneal hernia repair builds on the 20-year debate between traditional open versus laparoscopic inguinal hernia. In 2018, 80% of all inguinal hernia are repaired using an open technique, despite two decades of training and experience with laparoscopic inguinal hernia surgery. The robotic technique is based on the well-delineated transabdominal preperitoneal (TAPP) laparoscopic inguinal hernia repair. The lack of adoption of minimally invasive (MIS) techniques in inguinal hernia runs counter to trends of MIS increased adoption for procedures such as appendectomy, colectomy, cholecystectomy, and even ventral hernia. One would expect that adding more potential cost to the high cost of a laparoscopic inguinal repair would decrease the perceived value of the robotic inguinal hernia. This does not appear to be the case, as early trends are showing migration of both open and laparoscopic surgeons to the robotic platform. The central questions this chapter will address are how can the cost of robotic inguinal hernia surgery be minimized and in which patient population does the value proposition become positive.


Robotic Inguinal Hernia Mesh Recurrence Outcomes Value Transabdominal Preperitoneal Bilateral 


  1. 1.
    Hussain A, Malik A, Halim MU, Ali AM. The use of robotics in surgery: a review. Int J Clin Pract. 2014;68(11):1376–82.CrossRefGoogle Scholar
  2. 2.
    Collins JN, Britt RC, Britt LD. Concomitant robotic repair of inguinal hernia with robotic prostatectomy. Am Surg. 2011;77(2):238–9.PubMedGoogle Scholar
  3. 3.
    Joshi AR, Spivak J, Rubach E, Goldberg G, DeNoto G. Concurrent robotic trans-abdominal pre-peritoneal (TAP) herniorrhaphy during robotic-assisted radical prostatectomy. Int J Med Robot. 2010;6(3):311–4.CrossRefGoogle Scholar
  4. 4.
    Lee DK, Montgomery DP, Porter JR. Concurrent transperitoneal repair for incidentally detected inguinal hernias during robotically assisted radical prostatectomy. Urology. 2013;82(6):1320–2.CrossRefGoogle Scholar
  5. 5.
    Finley DS, Savatta D, Rodriguez E, Kopelan A, Ahlering TE. Transperitoneal robotic-assisted laparoscopic radical prostatectomy and inguinal herniorrhaphy. J Robot Surg. 2008;1(4):269–72.CrossRefGoogle Scholar
  6. 6.
    Ito F, Jarrard D, Gould JC. Transabdominal preperitoneal robotic inguinal hernia repair. J Laparoendosc Adv Surg Tech A. 2008;18(3):397–9.CrossRefGoogle Scholar
  7. 7.
    Engan C, Engan M, Bonilla V, Dyer DC, Randall BR. Description of robotically assisted single-site transabdominal preperitoneal (RASS-TAPP) inguinal hernia repair and presentation of clinical outcomes. Hernia. 2015;19(3):423–8.CrossRefGoogle Scholar
  8. 8.
    Waite KE, Herman MA, Doyle PJ. Comparison of robotic versus laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair. J Robot Surg. 2016;10(3):239–44.CrossRefGoogle Scholar
  9. 9.
    Escobar Dominguez JE, Ramos MG, Seetharamaiah R, Donkor C, Rabaza J, Gonzalez A. Feasibility of robotic inguinal hernia repair, a single-institution experience. Surg Endosc. 2016;30(9):4042–8.CrossRefGoogle Scholar
  10. 10.
    Arcerito M, Changchien E, Bernal O, Konkoly-Thege A, Moon J. Robotic inguinal hernia repair: technique and early experience. Am Surg. 2016;82(10):1014–7.PubMedGoogle Scholar
  11. 11.
    Iraniha A, Peloquin J. Long-term quality of life and outcomes following robotic assisted TAPP inguinal hernia repair. J Robot Surg. 2017. doi: Scholar
  12. 12.
    Kudsi OY, McCarty JC, Paluvoi N, Mabardy AS. Transition from laparoscopic totally extraperitoneal inguinal hernia repair to robotic transabdominal preperitoneal inguinal hernia repair: a retrospective review of a single surgeon’s experience. World J Surg. 2017;41(9):2251–7.CrossRefGoogle Scholar
  13. 13.
    Escobar Dominguez JE, Gonzalez A, Donkor C. Robotic inguinal hernia repair. J Surg Oncol. 2015;112(3):310–4.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of SurgeryUniversity of TennesseeKnoxvilleUSA

Personalised recommendations