Concomitant groin hernia repair during robotically-assisted prostatectomy

Inguinal hernia repair is one of the most common general surgical procedures performed in the world. Multiple approaches have been described including several laparoscopic approaches. The transabdominal preperitoneal repair (TAPP) is an ideal approach when other laparoscopic or robotic abdominal procedures are being performed. Robotic assisted laparoscopic prostatectomy is becoming the most popular approach for radical prostatectomy in the US Following radical prostatectomy, patients are at a higher risk of developing an inguinal hernia, likely from the extensive dissection. Those patients with known inguinal hernias and hernias found incidentally during prostatectomy should be considered for repair. For surgeons experienced with the TAPP repair, concomitant hernia repair can be safely performed with some variation in the technique, given the initial dissection performed by the urologist and the presence of a vesicourethral anastomosis. The robot is used for the hernia defect dissection and the mesh is placed laparoscopically. This approach has been shown to be safe and feasible.