Current state of robotic use in inguinal hernia repair: a survey of minimally invasive hernia surgeons

Little is known about how robot technology is employed by surgeons in minimally invasive surgery (MIS). We evaluated the needs of established robotic surgeons and of those who are new to this technology. A survey was designed and sent electronically to MIS surgeons. Questions included fellowship training, area of expertise, experience with robotic simulation and in clinical use, mentorship, likelihood of switching to a different approach, and expectations for the robot. Descriptive analysis was conducted using STATA/MP 15.1. 189 interviewees self-identified as hernia surgeons. 73.8% had additional fellowship, with majority practicing for 3-6 years (54%). Nearly 40% were MIS surgeons (N = 73), followed by general surgery (34.4%), and bariatrics (13.8%). 146 interviewees (77.7%) have used the daVinci(R) in clinical scenarios. Among robotic surgeons, majority were performing less than ten robotic cases per month. Inguinal hernia repairs were the leading procedures (49%), followed by foregut-related (19.5%), and colorectal-related surgeries (17.5%). Nearly 40% of surgeons stated inguinal hernia repairs to be the most often performed procedure using the robot. Nearly 40% of open and laparoscopic hernia surgeons are willing to adopt robotic-assisted procedures for their inguinal hernia repairs. Level 1 evidence (47.9%) and cost (24.1%) were the most pressing needs for robotic research. Majority of interviewees have used the daVinci(R) in clinical settings. Hernia repair remains the primary application of the robot in general surgery, among specialized surgeons. Over 40% of hernia surgeons are interested in switching to robotic technology over its open or laparoscopic counterparts.