First Results of Pediatric Robotic Inguinal Hernia Repair with the Senhance® Surgical System: A Matched Cohort Study

Introduction: Inguinal hernia repair (IHR) is one of the most common procedures in pediatric surgery. In children, the application of robotic surgery is limited, meaning safety and efficacy is still to be assessed. This report is the first one worldwide that describes inguinal hernia repair in children using the Senhance (R) Surgical System (SSS (R)). The aim of this matched cohort study is to assess safety and feasibility of robot-assisted IHR (RIHR) in children, compared to conventional laparoscopic IHR (LIHR). Patients and methods: This pilot study included 26 consecutive patients between 3 months and 8 years old who underwent RIHR (31 IH's) with the SSS (R) between 2020 and 2024. These cases were matched based on gender, age, and unilateral or bilateral IH, with 26 patients (32 IH's) who underwent conventional LIHR. Results: There was a significant difference in total anesthesia time, which is most likely due to the extra time needed to dock the robot in the RIHR cases. No significant difference was seen in surgical time. One recurrence (3.2%) was diagnosed in both groups. One patient in the LIHR group was readmitted on the day of discharge due to a hemorrhage. No intervention was necessary, and the patient was discharged 1 day later. Discussion: In this pilot study, the use of the robotic system was safe and feasible. More experience, further improvement of the system for use in very small children, and investigation in a larger sample size with long-term follow-up is necessary to evaluate efficacy.