Robotic versus Laparoscopic Inguinal Hernia Repair; A Prospective Study

Abstract Background Robotic inguinal hernia repair has certain advantages over laparoscopic repair including less pain and earlier return to normal activity. Robotic surgery adds high definition visualization and articulating instruments. This enhanced dexterity can make laparoscopic hernia repair more refined while obtaining a critical view of the myopectineal orifice that should lead to fewer recurrences and complications. Aim of the Work To compare early postoperative outcomes and surgical ergonomics between robotic and laparoscopic inguinal hernia repair. Patients and Methods This study is a prospective study, conducted in Ain Shams specialized Hospital during one year (March 2022 - March 2023). Patients above 16 year old who had inguinal hernia. Results The RULA was used to assess the ergonomic status of surgeons involved in this trial. RULA is a survey method originally developed for use in workplaces where risk exists for work-related upper limb injuries, often related to poor ergonomics combined with repetitive motion. It provides an assessment of the postures of the neck, trunk, and upper limb along with muscle function and the external loads experienced. The NASA-TLX validated instrument was used to determine the mental workload of surgeons, and has precedent as a tool to evaluate the mental workload of surgeons in minimally invasive surgery. The NASA-TLX provides an overall index of mental workload as well as the relative contribution of 6 subscales: mental, physical, and temporal task demands, effort, frustration, and perceived performance. Mental demand determines the level of intellectual and perceptual work required for completion of a task and physical demand determines the level of physical work required for completion of a task. Temporal demand is the measure for time pressure during the completion of the task. The effort component assesses mental and physical work required to perform at a certain proficiency level. Conclusion The benefits provided by the robotic platform include better visualization, improved ergonomics and wristed movements allowing for easier dissection.