The safety and feasibility of simultaneous robotic repair of an inguinal hernia during robotic-assisted laparoscopic prostatectomy: a systematic review and meta-analysis

Purpose
This study intended to assess the safety and feasibility of performing concurrent robotic-assisted laparoscopic prostatectomy (RALP) and robotic inguinal hernia repair (RIHR).

Method
We systematically searched the PubMed, Embase and Cochrane Library database up to the year 2020 to identify studies that assessed patients who underwent RALP and RIHR in the same settings.

Results
Thirteen studies were considered suitable for a systematic review and seven for Meta-analysis. RALP and RIHR were associated with significantly longer operative time. RIHR added on average 26 min to the operation time (8, 45 95% CI, p = 0.005, I2 97%). Concurrent RALP and RIHR was not associated with a higher incidence of blood loss (−13, 6 95% CI, p = 0.43, I2 18%), length of stay (−0.08, 0.06 95% CI, p = 0.73, I2 0%) or early postoperative complications.

Conclusion
Concurrent robotic repair of an inguinal hernia during RALP appears feasible and safe. Urologists should be encouraged to repair hernias encountered during RALP keeping in mind possible complications including wound infection, mesh infection, chronic inguinal pain and recurrence of hernia.