There is no difference in clinical benefit between the robotic and laparoscopic approach to straightforward unilateral inguinal hernia repair, suggests a study published in JAMA Surgery.
The multicentre, single-blinded, prospective randomised RIVAL trial compared standard laparoscopic transabdominal preperitoneal repair with robotic transabdominal preperitoneal repair for unilateral primary or recurrent inguinal hernia.
Outcomes included postoperative pain, health-related quality of life, cost, surgeon ergonomics, and surgeon mental workload.
A total of 102 patients were included (54 in the laparoscopic group and 48 in the robotic group).
There were no differences at the preoperative, one-week, or 30-day points between the groups in terms of wound events, re-admissions, pain, or quality of life.
Compared with traditional laparoscopic repair, robotic repair was associated with longer median operative times (P<.001 higher median cost and mean frustration levels on the href="https://ntrs.nasa.gov/archive/nasa/casi.ntrs.nasa.gov/20000021488.pdf" target="">NASA Task Load Index Scale (range 1-100 with lower scores indicating lower cognitive workload; 32.7 vs 20.1; P=.004).
The findings show no clinical benefit with the robotic approach to straightforward inguinal hernia repair compared with the laparoscopic approach. However, the robotic approach incurred higher costs and more operative time compared with the laparoscopic approach, with added surgeon frustration and no ergonomic benefit to surgeons.