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

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/m², 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.