title: Robot-assisted laparoscopic total extraperitoneal hernia repair during prostatectomy: technique and initial experience.
abstract: BACKGROUND
  To describe the technique of total extraperitoneal inguinal hernia repair performed during Robot-assisted Endoscopic Extraperitoneal Radical Prostatectomy (R-EERPE) and to present the initial outcomes.
  
  
  METHODS
  12 patients underwent inguinal hernia repair during 120 R-EERPEs performed between July 2011 and March 2012. All patients had a clinically palpable inguinal hernia preoperatively. The hernia was repaired using a Total Extraperitoneal Patch (TEP) at the end of the procedure.
  
  
  RESULTS
  Sac dissection and mesh placement was simpler compared to conventional laparoscopy due to improved, magnified, 3-D vision along with 7° of movement, and better control of mesh placement. The median operating time was 185 minutes, with on average, an additional 12 minutes incurred per hernia repair. The median blood loss for the procedures was 250 ml, and the mean pathological prostate weight was 55 gm. No additional blood loss was noted and there were no postoperative complications. None of the patients had a recurrence at 12 months. We await long-term follow-up data.
  
  
  CONCLUSIONS
  Robot-assisted TEP is feasible and should be considered in patients with hernia at the time of R-EERPE.
authors.affiliation: Department of Urology, University of Leipzig, Leipzig, Germany.
authors.forename: Hasan A R
authors.initials: HA
authors.lastname: Qazi
authors.affiliation: Department of Urology, University of Leipzig, Leipzig, Germany.
authors.forename: Bhavan Prasad
authors.initials: BP
authors.lastname: Rai
authors.affiliation: Department of Urology, University of Leipzig, Leipzig, Germany.
authors.forename: Minh
authors.initials: M
authors.lastname: Do
authors.affiliation: Department of Urology, University of Leipzig, Leipzig, Germany.
authors.forename: Matthew
authors.initials: M
authors.lastname: Rewhorn
authors.affiliation: Department of Urology, University of Leipzig, Leipzig, Germany.
authors.forename: Tim
authors.initials: T
authors.lastname: Häfner
authors.affiliation: Department of Urology, University of Patras, Patras, Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Liatsikos
authors.affiliation: Department of Urology, University of Leipzig, Leipzig, Germany ; Department of Urology, University of Patras, Patras, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Kallidonis
authors.affiliation: Department of Urology, University of Leipzig, Leipzig, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Dietel
authors.affiliation: Department of Urology, University of Leipzig, Leipzig, Germany.
authors.forename: Jens Uwe
authors.initials: JU
authors.lastname: Stolzenburg
keywords: extraperitoneal; hernia; mesh; prostatectomy; robot assisted