Robotic-Assisted Groin Hernia Repair tied to higher operative Recurrence versus laparoscopic techniques: JAMA

A cohort study published in the Journal of the American Medical Association showed that robotic-assisted repair for groin hernia was associated with a higher long-term cumulative incidence of operative recurrence when compared to open and laparoscopic techniques. Although overall recurrence rates were low across all approaches, these findings suggest the need for alternative measures of clinical value when evaluating minimally invasive and robotic-assisted procedures.

This study analyzed data from almost 200,000 Medicare beneficiaries aged 65 and older who underwent groin hernia repair between 2010 and 2021. The study tracked patients for up to 5 years after surgery, by comparing robotic-assisted, laparoscopic, and traditional open repair.

Over the 11-year period, the use of robotic-assisted surgery rose nearly 8-fold, but it still represents a relatively small share of procedures overall. At the same time, open surgeries declined significantly, while laparoscopic techniques saw steady growth, which reflected a broader shift toward minimally invasive care.

This study found that patients who underwent robotic-assisted repairs experienced the highest rate of hernia recurrence within 5 years. About 3.78% of these patients required another operation, when compared to 3.37% for open surgery and 3.21% for laparoscopic procedures.

After adjusting for factors such as age, health conditions, and hernia type, laparoscopic surgery emerged as the approach with the lowest risk of recurrence. It was associated with a 25% lower risk of repeat surgery when compared to open repair. Meanwhile, robotic-assisted procedures did not show a statistically significant improvement compared to open surgery in preventing recurrence.

While robotic surgery offers advantages such as enhanced precision and improved visualization for surgeons, these benefits did not translate into better outcomes in terms of recurrence in this study. The outcomes caution that recurrence is only one measure of surgical success.

Other factors like the recovery time, postoperative pain, complication rates, and patient satisfaction, may also play a crucial role in determining the overall value of different techniques. Robotic-assisted surgery, for instance, may still offer advantages in certain complex cases or specific patient populations.

With relatively low recurrence rates across all methods, the differences are observed to be small in absolute terms Future dedicated studies on the traditional and robotic approaches for hernia repair may help identify the broader benefits for patients.

Source:

Niba, V. S., Howard, R. A., Thumma, J., Norton, E. C., Dimick, J. B., & Sheetz, K. (2026). Surgical approach and long-term operative recurrence following groin hernia repair. JAMA Surgery. https://doi.org/10.1001/jamasurg.2026.1126