Perioperative Outcomes After Robotic Inguinal Hernia Repair in Patients With BMI ≥ 35 kg/m2: A Retrospective Cohort Study

Introduction: Although robotic inguinal hernia repair (RIHR) is increasingly utilized, limited data exist regarding its safety in patients with body mass index (BMI) ≥ 35 kg/m2. This study compares perioperative outcomes and 24-month recurrence rates following RIHR between patients with BMI < 35 kg/m2 and BMI ≥ 35 kg/m2. Methods: A retrospective review was conducted for adult patients undergoing RIHR between February 2019 and July 2022 at a single quaternary care center. Patients were stratified into BMI < 35 kg/m2 and BMI ≥ 35 kg/m2. Demographics, comorbidities, perioperative variables, postoperative complications, and recurrence rates within two years were analyzed. Propensity score matching was performed for age, sex, and hernia type. Results: A total of 106 patients underwent RIHR, including 90 patients (84.9%) with BMI < 35 kg/m2 and 16 patients (15.1%) with BMI ≥ 35 kg/m2. No statistically significant differences were observed in operative time, estimated blood loss, or postoperative complications. Rates of hernia recurrence were comparable between the two groups at 24 months. Conclusion: Our study shows that RIHR has comparable perioperative outcomes and 24-month recurrence rates in patients with BMI < 35 kg/m2 and BMI ≥ 35 kg/m2. These findings suggest that elevated BMI alone should not preclude RIHR.