Concurrent transperitoneal repair for incidentally detected inguinal hernias during robotically assisted radical prostatectomy.

Lee, Daniel K; Montgomery, Daniel P; Porter, James R

OBJECTIVE To report our experience with concurrent intraperitoneal inguinal herniorrhaphy using prosthetic mesh during robotically assisted radical prostatectomy (RARP) for incidentally discovered inguinal hernias. METHODS We performed a retrospective review of 1118 consecutive RARPs performed by one surgeon between July 2005 and July 2011. Cases that included concurrent hernia repair were compared with a group of patients matched 1:1 for age, body mass index, and year of surgery, who underwent RARP alone (controls). RESULTS A total of 91 patients underwent 113 concurrent inguinal hernia repairs during RARP. Twenty-two patients (24%) underwent bilateral repair. Of the 69 patients undergoing unilateral repair, 41 (45%) underwent left-sided repair, and 29 (31%) underwent right-sided repair. Thirty-five (38%) patients had previous inguinal hernia repair. Body mass index of cases and controls were 27.5 ± 3.4 and 27.8 ± 3.1 kg/m(2), respectively. Mean operative time in cases was 185 ± 28 minutes vs 168 ± 31 minutes in controls (P <.001). Estimated blood loss was 170 ± 61 mL for cases vs 194 ± 82 mL for controls (P = .03). No differences were observed in length of stay or prevalence of postoperative complications. There was 1 hernia recurrence, which necessitated repeat repair 1 year after surgery. No mesh infections or other complications related to hernia repairs were observed. CONCLUSION Inguinal hernias are a common intraoperative finding during RARP. Concurrent repair appears safe and effective with only a slight increase in operative time, and no increase in morbidity.