Robotic or laparoscopic inguinal hernia repair? A narrative review of the current literature

Abstract

Robotic inguinal hernia repair remains in the early stages of implementation, and its potential advantages over the laparoscopic approach are still a matter of debate. This narrative review aims to summarize the findings of major systematic reviews and randomized controlled trials and explore variables not adequately addressed in those studies. The literature review indicates that robotic inguinal hernia repair is associated with longer operative times but has improved ergonomics compared with laparoscopy. It is a safe procedure that results in a reduced inflammatory response, similar complication rates, and no significant difference in acute postoperative pain. Although it involves higher direct costs, its cost-effectiveness remains unclear owing to a lack of analysis including indirect costs. Ongoing controversy continues regarding long-term benefits. The most recent systematic review pointed towards lower recurrence rates with robotic surgery, although randomized controlled trials have not validated this finding. Data on chronic pain are currently insufficient to draw firm conclusions. Further studies are needed to assess its use in complex cases and the role of novel techniques.