Single-stage robot-assisted repair of symptomatic inguinal and Morgagni hernias in an adult male.

Abstract

Abstract: While laparoscopic and robotic repair of diaphragmatic hernias has recently become commonplace, minimally invasive single-stage procedures combining diaphragmatic hernia repair with another procedure remain rare. Our patient is a 61-year-old male presenting with a left-sided inguinal bulge and later dyspnoea, found to have concomitant left inguinal hernia and Morgagni-type diaphragmatic hernia. The patient was taken to the operating room for simultaneous robotic repair of both hernias. The procedure was completed robotically using two different docking orientations with the same three 8-mm port sites. The inguinal hernia was repaired using a standard transabdominal preperitoneal approach, and the Morgagni hernia was repaired primarily and reinforced with porcine biologic mesh. The procedure was without complication and the patient's symptoms resolved. We infer from our experience that simultaneous robotic repair of multiple hernia types is feasible and may decrease patient anaesthesia episodes as well as surgeon fatigue associated with laparoscopic and open approaches.