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Case Report
 
Robotic repair of Amyand's hernia: A case report
Thomas J. Shaknovsky1, Frederick Sabido2, Dooniya Shaikh3, Phillip L. Rosen4
1DO, Southeast Alabama Medical Center/Alabama College of Osteopathic Medicine, General Surgeon/Clinical Professor, Dothan, AL USA.
2MD FACS, Richmond University Medical Center, Director of Minimally Invasive Surgery Fellowship, Staten Island, NY USA.
3BS, Richmond University Medical Center, Medical Student, Staten Island, NY USA.
4MD, Richmond University Medical Center – General Surgery Resident, Staten Island, NY USA.

Article ID: 100032Z12TS2016
doi:10.5348/Z12-2016-32-CR-24

Address correspondence to:
Thomas J, Shaknovsky

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How to cite this article:
Shaknovsky TJ, Sabido F, Shaikh D, Rosen PL. Robotic repair of Amyand's hernia: A case report. J Case Rep Images Surg 2016;2:92–96.


Abstract
Introduction: Inguinal hernia repair is the most common procedures in general surgery. Contents within the hernia sac are variable and in rare cases, the hernia sac contains the vermiform appendix termed Amyand's Hernia. While laparoscopic technique is the most accepted approach, few prospective studies have been completed comparing laparoscopic versus robotic techniques for hernia repair and none in the setting of an Amyand's hernia. We describe the first documented robotic approach to the repair of Amyand's hernia.
Case Report: A 40-year-old male presented to outpatient surgery clinic with complaint of right scrotal mass. He was diagnosed with right inguinal hernia and was electively scheduled for robotic repair with mesh. Intraoperatively, type 1 Amyand's hernia was discovered. Using robotic technique the hernia was reduced and successfully repaired with mesh. Patient postoperative course was unremarkable.
Conclusion: Amyand's hernia is a rare subtype of inguinal hernia containing vermiform appendix within the hernia sac. Management of Amyand's hernia is surgery and extent of intervention is dictated by pathology of the vermiform appendix. While open and laparoscopic techniques have been well documented, robotic approach is safe, effective and provides a surgeon with a unique advantage in repair of Amyand's hernia. The robotic platform Da Vinci Surgical System's 3D high definition imaging coupled with advanced degree of dissection control provides a surgeon with a unique advantage over open and laparoscopic techniques. Robotic approach to repair of Amyand's hernia is safe and effective.

Keywords: Amyand's hernia, Appendectomy, Incarcerated Amyand's hernia, Robotic herniorrhaphy, Robotic inguinal hernia


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Author Contributions
Thomas J. Shaknovsky – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Frederick Sabido – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Dooniya Shaikh – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Phillip L. Rosen – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 Thomas J. Shaknovsky et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



About The Authors

Thomas J. Shaknovsky is a General Surgeon specializing in robotic and minimally invasive surgery at Southeast Alabama Medical Center in Dothan, Alabama. He also serves as a Clinical Professor at Alabama College of Osteopathic Medicine in Dothan, Alabama. He earned undergraduate (BS degree) from Loyola University Chicago in Chicago, Illinois and medical degree from Midwestern University, Chicago College of Osteopathic Medicine in Downers Grove, Illinois. He completed his general surgery residency at Hackensack Medical Center, Palisades in North Bergen, New Jersey. He also completed a Burn Surgery Fellowship at John H. Stroger Hospital of Cook County in Chicago, Illinois and Minimally Invasive Surgery Fellowship in Staten Island, New York. He has published eight research papers in national and international academic journals. His research interests include minimally invasive, robotic surgery.



Frederick Sabido is Director of Minimally Invasive Surgery and Fellowship Program Director in the Department of Surgery at Richmond University Medical Center an Affiliate of the Mount Sinai Hospital and Icahan School if Medicine. Dr. Sabido is a graduate of the 7 year B.S./M/D accelerated program at New York University School of Medicine and has published over 25 peer reviewed research papers in national and international academic journals and has authored one textbook.



Dooniya Shaikh is a 4th year medical student at Richmond University Medical Center in Staten Island, New York. She earned undergraduate degree (Bachelor of Science in Biology) from University of Illinois at Chicago and currently working on her postgraduate degree - Doctor of Medicine from St. George's University. Her research interests include minimally invasive surgery, robotics, and critical care.



Philip Rosen is a Resident in the Department of Surgery at SUNY Downstate, New York City. He earned both his undergraduate and medical degree from the University of Pennsylvania.