Evidence map›Paper›PMID 42538397›Full record

ArticleSurgical endoscopy2026

First United States experience of robotic-assisted minimally invasive inguinal hernia repair using the Dexter surgical system.

Nikita S Thareja, Graham J Spurzem, Ana Garcia Cabrera, J Jeffery Reeves, Hannah M Hollandsworth, Bryan J Sandler, Garth R Jacobsen, Ryan C Broderick

Abstract read
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Article in Surgical endoscopy, 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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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Nikita S TharejaDivision of Minimally Invasive Surgery, University of California, San Diego (UCSD), 9300 Campus Point Drive, La Jolla, CA, 92037, USA.ORCID http://orcid.org/0009-0005-1710-3035
Graham J SpurzemDivision of Minimally Invasive Surgery, University of California, San Diego (UCSD), 9300 Campus Point Drive, La Jolla, CA, 92037, USA.
Ana Garcia CabreraDivision of Minimally Invasive Surgery, University of California, San Diego (UCSD), 9300 Campus Point Drive, La Jolla, CA, 92037, USA.
J Jeffery ReevesDivision of Minimally Invasive Surgery, University of California, San Diego (UCSD), 9300 Campus Point Drive, La Jolla, CA, 92037, USA.
Hannah M HollandsworthDivision of Minimally Invasive Surgery, University of California, San Diego (UCSD), 9300 Campus Point Drive, La Jolla, CA, 92037, USA.
Bryan J SandlerDivision of Minimally Invasive Surgery, University of California, San Diego (UCSD), 9300 Campus Point Drive, La Jolla, CA, 92037, USA.
Garth R JacobsenDivision of Minimally Invasive Surgery, University of California, San Diego (UCSD), 9300 Campus Point Drive, La Jolla, CA, 92037, USA.
Ryan C BroderickDivision of Minimally Invasive Surgery, University of California, San Diego (UCSD), 9300 Campus Point Drive, La Jolla, CA, 92037, USA. rbroderick@health.ucsd.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRobotic-assisted inguinal hernia repair continues to evolve with the introduction of novel surgical platforms designed to improve costs, workflow integration, and ergonomics. The Dexter Surgical System has recently entered clinical practice; however, its use for inguinal hernia repair in the USA has not been reported. This study evaluated feasibility, safety, and early operative outcomes in a United States cohort.

methodsA retrospective review was conducted of consecutive patients undergoing robotic inguinal hernia repair with Dexter at a single academic center between November 2024 and November 2025. Primary outcomes included intraoperative complications, device-related adverse events, and conversion to open or laparoscopic surgery. Secondary outcomes included operative time, console time, docking time, length of stay, and 30-day outcomes. Learning curve analysis was performed using cumulative sum methodology, along with a comparison of the primary surgeon's first five versus final five cases.

resultsTwenty-six patients underwent robotic inguinal hernia repair performed by two fellowship-trained minimally invasive surgeons with extensive prior robotics experience. All procedures were completed without conversion, complications, or device-related events, and all patients were discharged the same day. Mean operative time was 63.1 ± 18.5 min, with mean console time of 38.5 ± 15.7 min and docking time of 6.1 ± 2.2 min. One patient (3.8%) developed postoperative pneumonia requiring admission and intravenous antibiotics; no other 30-day complications, readmissions, or reoperations occurred. CUSUM analysis identified an inflection point at case six, after which operative times trended below the mean. Mean operative time decreased from 66.8 ± 11.1 min in the first five cases to 54.0 ± 13.3 min in the final five.

conclusionThis first United States experience demonstrates that robotic inguinal hernia repair using Dexter is feasible and safe in the outpatient setting, with favorable outcomes, efficient operative times, and a rapid learning curve among experienced surgeons.

Indexed as

Hernia, InguinalHerniorrhaphyRobotic Surgical ProceduresAdultAgedFeasibility StudiesFemaleHumansLaparoscopyLearning CurveLength of StayMaleMiddle AgedOperative TimePostoperative ComplicationsRetrospective StudiesCUSUMDexter Surgical SystemInguinal hernia repairLearning curvesNovel robotic systems

Identifiers

PMID42538397

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.