title: Case report of a robotic-assisted laparoscopic repair of a giant incarcerated recurrent inguinal hernia containing bladder and ureters.
abstract: BACKGROUND
  Robotic surgery is particularly useful in pelvic procedures, such as prostatectomy and low anterior resection. The paper describes a robotic-assisted repair of a giant bladder- and ureter-containing incarcerated inguinal hernia.
  
  
  RESULTS
  A 53-year-old man had previously undergone repair of a left inguinal hernia. He presented to our clinic complaining of difficulty urinating and a large bulge in his left scrotum. CT revealed a giant left scrotal hernia containing the bladder and both ureters. The patient underwent robotic-assisted laparoscopic repair. The bladder and both ureters were carefully dissected free from the scrotum, while preserving the testicle and spermatic cord. A 6×4 inch pre-peritoneal polyester composite mesh was then used to repair the defect.
  
  
  CONCLUSIONS
  Incarcerated, recurrent inguinal hernias are challenging repairs. Robotic-assisted repair allows for fine dissection, and is an excellent alternative to open surgery for a difficult inguinal hernia.
authors.affiliation: Department of Surgery, Einstein Healthcare Network, Philadelphia, PA.
authors.forename: Lawrence N
authors.initials: LN
authors.lastname: Cetrulo
authors.forename: Justin
authors.initials: J
authors.lastname: Harmon
authors.forename: Jorge
authors.initials: J
authors.lastname: Ortiz
authors.forename: Daniel
authors.initials: D
authors.lastname: Canter
authors.forename: Amit R T
authors.initials: AR
authors.lastname: Joshi
mesh_terms: D006552:Hernia, Inguinal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D065287:Robotic Surgical Procedures / Q000379:methods*; D014057:Tomography, X-Ray Computed; D014513:Ureter / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*
keywords: bladder; inguinal hernia; robotic surgery