Robotic repair of Amyand's hernia: A case report

Abstract

Introduction: Inguinal hernia repair is the most common procedures in general surgery. Contents within the hernia sac are variable and in rare cases, the hernia sac contains the vermiform appendix termed Amyand's Hernia. While laparoscopic technique is the most accepted approach, few prospective studies have been completed comparing laparoscopic versus robotic techniques for hernia repair and none in the setting of an Amyand's hernia. We describe the first documented robotic approach to the repair of Amyand's hernia. Case Report: A 40-year-old male presented to outpatient surgery clinic with complaint of right scrotal mass. He was diagnosed with right inguinal hernia and was electively scheduled for robotic repair with mesh. Intraoperatively, type 1 Amyand's hernia was discovered. Using robotic technique the hernia was reduced and successfully repaired with mesh. Patient postoperative course was unremarkable. Conclusion: Amyand's hernia is a rare subtype of inguinal hernia containing vermiform appendix within the hernia sac. Management of Amyand's hernia is surgery and extent of intervention is dictated by pathology of the vermiform appendix. While open and laparoscopic techniques have been well documented, robotic approach is safe, effective and provides a surgeon with a unique advantage in repair of Amyand's hernia. The robotic platform Da Vinci Surgical Systems 3D high definition imaging coupled with advanced degree of dissection control provides a surgeon with a unique advantage over open and laparoscopic techniques. Robotic approach to repair of Amyand's hernia is safe and effective.