SynthesisHernia : the journal of hernias and abdominal wall surgery2026
Concurrent inguinal hernia repair during robotic radical prostatectomy: a systematic review and meta-analysis.
Synthesis in Hernia : the journal of hernias and abdominal wall surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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11 authors.
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Abstract
purposeInguinal hernias are commonly encountered during robotic-assisted radical prostatectomy (RARP), either preoperatively or intraoperatively. Performing concurrent inguinal hernia repair (IHR) at the time of RARP may prevent the morbidity, cost, and inconvenience associated with a second operation. This systematic review and meta-analysis aimed to evaluate the safety and efficacy of concurrent IHR during RARP compared with RARP alone.
methodsThis study followed PRISMA guidelines and was prospectively registered with PROSPERO (CRD42025646245). Comprehensive searches of PubMed, EMBASE, and Cochrane CENTRAL were conducted to identify studies comparing outcomes of RARP with and without concurrent IHR. Primary outcomes included operative time, length of hospital stay, blood loss, and postoperative complications. A proportional meta-analysis was performed using a random-effects model, and heterogeneity was assessed using the I² statistic.
resultsTwenty studies comprising 1,402 patients who underwent concurrent IHR and 20,405 patients who underwent RARP alone were included. Concurrent IHR was associated with a statistically significant increase in operative time (mean difference 30.45 min; 95% CI 13.71-77.38) but showed no significant differences in postoperative complications, blood loss, or hospital stay. The pooled hernia recurrence rate was low (mean 1.9%), and Clavien-Dindo I-III complication rates were comparable between groups.
conclusionConcurrent IHR during RARP may be feasible, with perioperative outcomes broadly comparable to RARP alone. Concurrent repair may be considered in selected patients and experienced centres however given study heterogeneity and the predominance of retrospective evidence, these findings should be interpreted cautiously.
trial registrationThe trial was prospectively registered on PROSPERO on 03/02/2025 under ID: CRD42025646245.
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