Abstract:

Objective

To explore the feasibility and efficacy of robot-assisted laparoscopic parastomal hernia repair （Sugarbaker）.

Methods

A retrospective analysis was conducted on the clinical data of 7 cases of robot-assisted laparoscopic parastomal hernia repair completed in Union Medicine Center in Tianjin from March 2024 to July 2024.The method of All patients repaired was Sugarbaker.Observe and record the surgical situation， including operation time， intraoperative complications （intraoperative hemorrhage， intestinal injury）， and the occurrence of robotic system failure； postoperative recovery，including postoperative water intake， eating time， postoperative exhaust and defecation time， pain level on the first day after surgery， and postoperative hospital stay.Follow up the post-discharge complications，including stoma infections， intestinal obstruction， and hernia recurrence.

Results

All seven patients successfully underwent surgery without intraoperative complications or robotic system malfunctions.The operative time ranged from 150 to 240 minutes， with an intraoperative blood loss of 10 to 50 ml， and no intraoperative transfusions were required.Postoperatively， all patients were allowed oral water intake at 6 hours after surgery， followed by a liquid diet on postoperative day 1.The time to first flatus ranged from 1 to 3 days， with an average of 1.57 days， while the time to first bowel movement was 2 to 4 days， averaging 2.86 days.Postoperative pain was mild， with Numeric Rating Scale （NRS） scores on postoperative day 1 ranging from 2 to 4， with a mean of 2.71.The postoperative hospital stay ranged from 4 to 5 days， with an average of 4.29 days.During the 1-to 4-month follow-up period， one patient developed postoperative intestinal obstruction， which resolved with conservative treatment.No cases of stoma infection or hernia recurrence were observed.

Conclusion

Robot-assisted laparoscopic parastomal hernia repair is safe and effective， with a relatively low complication rate and short term recurrence rate， but the long-term effect needs to be further observed.

Key words: Robot-assisted, Hernia, parastomal, Sugarbaker, Herniorrhaphy