Robotic inguinal hernia repair in patients aged eighty and older

Abstract

BACKGROUND: Minimally invasive techniques, such as robotic inguinal hernia repair (RIHR), have potential benefits for patients in various clinical scenarios. However, the value of RIHR in older age groups has not yet been established, as increased age may place patients at a higher risk of postoperative morbidity and mortality. The aim of the study is to evaluate the feasibility of RIHR in patients ≥80 years old. MATERIALS AND METHODS: Among patients who underwent RIHR between February 2013 and August 2020, patients ≥80 years old were included. Preoperative, intraoperative, and postoperative variables were reviewed. Postoperative complications were assessed according to the Clavien–Dindo (CD) classification and the Comprehensive Complication Index (CCI®) scoring system. Univariate and multivariate analyses were used to identify the risk factors for patients with complications. RESULTS: A total of 51 patients were included in the study. The average operative time was 58.7 min. The average length of stay was 0.5 days. Urinary retention and seroma were the commonly encountered complications (CD Grades 1 and 2). A procedural intervention and overnight intensive care unit follow-up were needed in two patients for each (CD Grade-3a and-4a). The maximum morbidity CCI score was 43.3. There was no hernia recurrence or reoperation during the mean follow-up period of 42 months. No statistically significant difference was found between patients with and without complications. CONCLUSION: This is the first study to demonstrate the feasibility of RIHR in patients ≥ 80-year-old. Although advanced age is associated with increased comorbidities and physiological irregularities, RIHR may be performed with short operative time, length of hospital stay, and low rate of postoperative complications in these patients.

Keywords

• elderly
• groin hernia
• inguinal hernia
• octogenarian
• oldest old
• robotics