A global registry-based analysis of clinical trials on robotic-assisted inguinal hernia repair: current landscape and research gaps.

Robotic-assisted surgery is increasingly utilized for inguinal hernia repair, yet clinical trials evaluating its role remain limited. This study maps registered trials to identify research gaps and inform future investigations. We searched four major trial registries (ClinicalTrials.gov, ICTRP, EU-CTR, ISRCTN) to identify studies assessing robotic surgery for inguinal hernias or comparing it to laparoscopic or open repair. Trials reporting surgical outcomes were included. Of 77 studies identified, 12 trials registered between 2016 and 2023 met our criteria. Among these, 75% (n = 9) were observational, and 25% (n = 3) were interventional trials. Half of the studies (50%) compared robotic surgery to laparoscopic repair, 33.3% compared robotic to open surgery, and 16.7% included all three approaches. The primary endpoints most frequently reported were postoperative pain (41.7%, n = 5) and early postoperative or intraoperative complications (33.3%, n = 4). Secondary outcomes predominantly included late postoperative complications such as readmission and infection (58.3%, n = 7), quality of life (50%, n = 6), and recurrence rates (41.7%, n = 5). No trials from low-income regions were identified. Trials on robotic inguinal hernia repair are few and geographically concentrated in high-income countries. The findings highlight the need for more randomized controlled trials evaluating long-term outcomes and cost-effectiveness. This study serves as a foundation for future research and clinical guidelines.