Laparoscopic inguinal hernia repair with a joystick-guided robotic scope holder (Soloassist II®): retrospective comparative study with human assistant.

The purpose of this study was to evaluate the clinical usefulness of a joystick-guided robotic scope holder (Soloassist II®) in laparoscopic inguinal hernia repair. Among 182 inguinal hernia patients treated by laparoscopic transabdominal preperitoneal repair, 82 cases were completed with a human scope assistant, while Soloassist was used in 100 cases. We retrospectively compared perioperative results of Soloassist group and human scope assistant group. In 139 unilateral cases, we also used logistic regression of perioperative factors for the propensity score calculation to balance the bias. All operations with Soloassist were carried out laparoscopically as solo-surgery without any system-specific complications. A statistically significant decrease in operation time was observed in Soloassist group compared with human assistant group (93.6 vs 85.9 min, p = 0.05). There was no prolongation of preoperative time or difference in the amount of intraoperative blood loss. Operation time was also significantly shorter in Soloassist group, when analyzing unilateral cases (85.5 vs 76.3 min, p = 0.02) and bilateral cases (126.9 vs 111.8 min, p = 0.01), independently. However, after propensity score matching in unilateral cases, there was no statistically significant difference between the two groups (83.8 vs 77.2 min, p = 0.23). The feasibility of Soloassist in laparoscopic inguinal hernia repair was demonstrated with no adverse device-related events. All surgeries could be completed as solo-surgery, while no additional time for preoperative setting was required. The mean operation time tends to be shorter in Soloassist group compared with human assistant group. Soloassist could be an effective device in laparoscopic inguinal hernia repair.