Case report demonstrates safe emergency robotic hernia repair in an elderly patient with active influenza A, indicating feasibility with targeted infection and ventilation protocols.
BACKGROUND: Emergency repair of strangulated hernias in elderly patients with active respiratory viral infections is high risk and poorly described. This case reports the first emergency robotic-assisted transabdominal preperitoneal (r-TAPP) repair performed in an elderly patient with active influenza A infection, highlighting surgical and infection-control adaptations enabling safe outcomes. CASE SUMMARY: An 80-year-old male with significant comorbidities presented with a strangulated left inguinal hernia and confirmed influenza A (H3N2) infection, associated with abdominal pain, bowel obstruction, and mild hypoxaemia. Emergency robotic r-TAPP repair was performed using targeted modifications, including ultra-low-pressure pneumoperitoneum, ultra-low particulate air filtration, and lung-protective ventilation. Operative time was 85 minutes with minimal blood loss. The patient was extubated immediately postoperatively, experienced no complications, and was discharged on postoperative day two. Antiviral therapy was continued without respiratory deterioration or nosocomial transmission. CONCLUSION: Emergency robotic-assisted repair of strangulated hernia can be safely performed in selected elderly patients with active respiratory viral infection when appropriate surgical, anaesthetic, and infection-control strategies are applied.
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Evangelou et al. (2026) studied this question.