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Abstract
COMPARATIVE OUTCOMES OF LAPAROSCOPIC AND ROBOTIC INGUINAL HERNIA REPAIR: A NARRATIVE REVIEW
Amulya Akula*, Dr. M. Sai Venkata Pavan, Madhuri Routhu, Srujana Poloju, Sreemantula Divya, Dr. P. Sharath Chandra Kaushik
ABSTRACT
Repair of an inguinal hernia continues to be among the most frequent surgical procedures performed by general surgeons around the globe. Patients are still seeking for a method that will minimize their postoperative discomfort and accelerate their recovery. The question remains whether the traditional laparoscopic approach is better than the contemporary robotic technique. The objective of this review is to evaluate and compare the outcomes of laparoscopic versus robotic inguinal hernia repair focusing primarily on postoperative events such as the onset of pain following surgery, including pain during the first days post-surgery, pain that persists in the groin area months later, recurrence of hernia both early and late after the operation, any complications, hospital stay duration, ability to return to work, and quality of life. Both procedures produce fairly similar results on the patients' side. In terms of operation time, robotic surgery takes roughly 15-27 minutes longer than open surgery but is more expensive; nonetheless, the pain results are virtually identical in most of the review studies. The rate of recurrence remains very low, around 1-2 percent, and there is no clear evidence of either technique being superior. Other complications such as seroma formation, retention of urine, and wound problems happen equally frequently, yet in one extensive meta-analysis, a slightly higher risk of surgical site infections was associated with the robotic procedure. Hospital length of stay and recovery time are equal, and the quality of life improves relatively quickly irrespective of the selected technique. There is some evidence that, in more complicated cases, the robotic method may show a slight early edge regarding the need for fewer opioid pills and greater comfort on the part of the patient; however, randomized trials fail to prove this conclusively. Clinical implications and future perspectives: In terms of simple clinical indications such as routine cases of abdominal wall hernia, both methods are still safe procedures that can be trusted; however, it is important to mention the potential benefits that the use of robots brings in cases when there is an increased body mass index (BMI) and in recurring hernias due to improved 3D vision and suture placement assistance. It should be noted that the cost associated with the procedures and the increased time required for preparation makes it necessary to conduct further analysis.
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