title: Concurrent transperitoneal repair for incidentally detected inguinal hernias during robotically assisted radical prostatectomy.
abstract: 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/m(2), 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Swedish Urology Group, Swedish Medical Center, Seattle, WA. Electronic address: daniel-lee-1@uiowa.edu.
authors.forename: Daniel K
authors.initials: DK
authors.lastname: Lee
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Montgomery
authors.forename: James R
authors.initials: JR
authors.lastname: Porter
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D015897:Comorbidity; D006552:Hernia, Inguinal / Q000453:epidemiology / Q000601:surgery*; D059685:Herniorrhaphy; D006801:Humans; D033162:Incidental Findings; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene / Q000627:therapeutic use; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000601:surgery*; D019736:Prostheses and Implants; D012371:Robotics; D013526:Surgical Mesh
chemical_list: D011138:Polytetrafluoroethylene