Comparison between robotic and laparoscopic inguinal hernia repair in Caucasian patients: a systematic review and meta-analysis

BACKGROUND: Laparoscopic and robotic techniques allow surgeons to dissect and observe the groin area from the inside out, this study was to evaluate and compare the effects and safety of robotic inguinal hernia repair (R-IHR) and laparoscopic inguinal hernia repair (L-IHR) in Caucasian patients. METHODS: We searched the full texts of studies comparing R-IHR and L-IHR in multiple databases. Meta-, sensitivity, and bias analyses of the included literature were performed with Review Manager 5.2, and forest plots were drawn. The joint estimate of the risk ratio (RR) and the mean difference (MD) of the 95% confidence interval (CI) was used as a measure of the effect size. RESULTS: This meta-analysis included 8 eligible studies involving 1,379 Caucasian patients with inguinal hernia (IH). No significant difference was found in pain score (MD =1.52, 95% CI, −0.30, 3.35, P=0.10; I(2)=97%), length of hospital stay (MD =0.14, 95% CI, −0.03, 0.30, P for overall effect =1.63, I(2)=0%), or complications (RR =1.24 with 95% CI, 0.94, 1.63, P for overall effect =0.13, I(2)=0%) between R-IHR and L-IHR. However, there was significant difference in operative time between R-IHR and L-IHR (MD =17.17, 95% CI, 6.32, 28.03, P=0.002; I(2)=84%). DISCUSSION: This meta-analysis revealed only minor differences between R-IHR and L-IHR in terms of clinical effects and safety in Caucasian patients, although R-IHR has a longer operative time than L-IHR. Both R-IHR and L-IHR are suitable to treat Caucasian patients with IH.