Bilateral inguinal hernia is a common surgical condition that significantly affects a patient’s quality of life due to pain, discomfort, and limitations in daily activities. With the evolution of minimally invasive surgery, robotic-assisted techniques have emerged as a highly precise and patient-friendly option. Among these, Bilateral Robotic Inguinal Hernia Mesh Repair using the Transabdominal Preperitoneal (TAPP) approach with mesh suturing represents a refined and advanced method that combines anatomical accuracy with enhanced surgical ergonomics.

The robotic TAPP technique begins with proper patient positioning under general anesthesia, followed by port placement and docking of the robotic system. After creating pneumoperitoneum, the peritoneum is incised to access the preperitoneal space. Careful dissection is carried out to clearly identify key anatomical landmarks such as the inferior epigastric vessels, vas deferens, spermatic vessels, and the myopectineal orifice. This meticulous dissection is especially advantageous in bilateral hernias, as both sides can be addressed in a single operative session without repositioning.

Once the hernia sacs—direct, indirect, or pantaloon—are fully reduced, a large synthetic mesh is placed to cover the entire myopectineal orifice on each side. In robotic repair, mesh fixation by suturing is a notable advantage. The wristed robotic instruments allow precise intracorporeal suturing, ensuring secure mesh placement while minimizing the risk of nerve injury and chronic postoperative pain often associated with tack fixation. Suturing also provides excellent mesh stability, particularly in large or bilateral defects.

After mesh placement, the peritoneum is carefully closed using continuous sutures, restoring the natural anatomical barrier and preventing bowel adhesion to the mesh. The robotic platform offers superior three-dimensional visualization, tremor filtration, and ergonomic comfort, which collectively enhance surgical accuracy and reduce fatigue during bilateral procedures.

The benefits of bilateral robotic TAPP hernia repair include reduced postoperative pain, minimal blood loss, early ambulation, faster recovery, and excellent cosmetic outcomes. Patients typically experience a quicker return to normal activities and work compared to open or conventional laparoscopic techniques.

In conclusion, Bilateral Robotic Inguinal Hernia Mesh Repair by Suturing using the TAPP technique represents a significant advancement in hernia surgery. It combines the principles of minimally invasive surgery with robotic precision, offering safe, effective, and durable outcomes. As surgical expertise and access to robotic systems continue to expand, this technique is likely to become a preferred approach for managing bilateral inguinal hernias in modern surgical practice.