Case report of a robotic-assisted laparoscopic repair of a giant incarcerated recurrent inguinal hernia containing bladder and ureters

Abstract

Background: Robotic surgery is particularly useful in pelvic procedures, such as prostatectomy and low anterior resection. The paper describes a robotic-assisted repair of a giant bladder- and ureter-containing incarcerated inguinal hernia.

Methods and results: A 53-year-old man had previously undergone repair of a left inguinal hernia. He presented to our clinic complaining of difficulty urinating and a large bulge in his left scrotum. CT revealed a giant left scrotal hernia containing the bladder and both ureters. The patient underwent robotic-assisted laparoscopic repair. The bladder and both ureters were carefully dissected free from the scrotum, while preserving the testicle and spermatic cord. A 6×4 inch pre-peritoneal polyester composite mesh was then used to repair the defect.

Conclusion: Incarcerated, recurrent inguinal hernias are challenging repairs. Robotic-assisted repair allows for fine dissection, and is an excellent alternative to open surgery for a difficult inguinal hernia.

Keywords: bladder; inguinal hernia; robotic surgery.