Surgeons robotically completed 39 complex lateral abdominal wall hernia repairs with no conversion to open or conventional keyhole surgery,according to a new study published in Hernia.
The study was led by Dr. Michael Freund of the Hebrew University of Jerusalem (HU) Faculty of Medicine and Shaare Zedek Medical Center in collaboration with Prof. David Hazzan of Raphael Hospital, Sheba Medical Center and Tel Aviv University.
Robotic technology may simplify repairs of rare lateral abdominal wall hernias near ribs, pelvis, muscles, nerves, and blood vessels. In the study, most patients went home after one day and no hernias returned during a median follow-up of approximately 14 months in the study of surgeries from 2018 to 2025. As one of the largest studies of robotic lateral abdominal wall hernia repair using the da Vinci Robotic Surgical System, it suggests the technology may make these operations more precise and less invasive while shortening hospital stays.
“Robotic technology is changing what surgeons can do through small incisions,” said Dr. Freund. “It allowed us to reach one of the abdominal wall’s most unforgiving areas —surrounded by bone, muscle, nerves, and blood vessels — and rebuild it with remarkable precision, transforming an exceptionally difficult operation.”
Lateral Hernias: Difficult to Repair
A hernia occurs when tissue or an organ pushes through a weak area in the abdominal wall. Lateral hernias form along the body’s side rather than the groin or abdominal center. This location leaves little room to work or position reinforcing mesh; scar tissue and altered anatomy from previous operations can make repair harder. Most patients developed hernias after kidney, colorectal, spinal, or gallbladder surgery.
Robotic Surgery Advantages
Robotic Surgery: Revolutionizing Hernia Repairs
Open surgery may require a large incision and longer recovery, while conventional keyhole instruments can be difficult to maneuver at the angles needed for lateral hernias. Robotic instruments bend and rotate like a human wrist and provide a magnified, three-dimensional view. This helps surgeons reach and close the hernia and place large reinforcing mesh behind the muscle, separated from internal organs by tissue.
In another recent study of off-center abdominal hernias, some procedures were partly converted to open surgery, about one-third of patients had complications, and some hernias recurred. In this study, all operations remained robotic and none recurred during follow-up, though the different patient groups prevent direct comparison.
Encouraging Early Results
Most patients recovered with little pain and no complications. Two developed bowel obstructions requiring another laparoscopic procedure; both recovered without bowel removal.
The researchers caution that this small retrospective study did not directly compare robotic surgery with other methods and requires longer follow-up to assess durability.
Research Paper
Freund, M.R., Katz, E., Lahav, L. et al. “Robotic TAPP Repair of Lateral Abdominal Wall Hernias: A Multi-Center Experience.” Hernia 30, 329 (2026).
DOI: 10.1007/s10029-026-03835-z
Authors:
Michael R. Freund¹, Ephraim Katz²˒³, Lauren Lahav⁴, Alon Schwartz¹, Lior Segev²˒³, Yaron Rudnicki⁴, Shmuel Avital⁴, David Hazzan⁵
Affiliations:
- Department of General Surgery, Shaare Zedek Medical Center, The Hebrew University Faculty of Medicine, Jerusalem, Israel
- Department of Surgery, Sheba Medical Center, Ramat Gan, Israel
- The Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Department of Surgery, Meir Medical Center, The Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Raphael Hospital, Tel Aviv, Israel