To synthesize high-quality comparative evidence on robotic versus laparoscopic minimally invasive inguinal hernia repair through a systematic review and meta-analysis of randomized controlled trials (RCTs).
Approach:
Study Design: The systematic review and meta-analysis followed the PRISMA 2020 guidelines and was registered with PROSPERO.
Eligibility Criteria: Included RCTs enrolling adults aged ≥18 years undergoing minimally invasive inguinal hernia repair, comparing robotic and laparoscopic techniques.
Interventions: Eligible interventions included robotic transabdominal preperitoneal (r-TAPP) and robotic totally extraperitoneal (r-TEP) repairs, compared to laparoscopic techniques.
Outcomes: Primary outcomes included postoperative complications, recurrence, same-day discharge, and postoperative pain; secondary outcomes included chronic pain, operative duration, and patient-reported measures.
Literature Search: A comprehensive search was conducted across multiple databases without language or publication-year restrictions.
Key Findings:
Robotic inguinal hernia repair has seen a significant increase in adoption, particularly in the U.S. Veterans Affairs system.
Previous reviews lacked robust evidence and often included non-randomized studies, complicating the interpretation of outcomes.
The current meta-analysis aims to address methodological limitations and synthesize a broader range of outcomes.
Limitations:
Previous analyses included non-randomized studies, which may introduce bias.
Heterogeneity in outcome assessment and definitions complicates comparisons across studies.
Conclusion:
This systematic review and meta-analysis seeks to provide a comprehensive evaluation of robotic versus laparoscopic inguinal hernia repair outcomes.
