{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:04:11Z","timestamp":1790726651375,"version":"4.1.0"},"reference-count":4,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":29,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>While robotic transabdominal preperitoneal (R-TAPP) hernia repairs offer excellent visibility, literature overlooks time lost to technical troubleshooting. This technical note evaluates a 30-minute pre-incision delay during a routine R-TAPP procedure, precipitated by a software synchronization error and system positioning fault. Serial system cycles, mechanical recalibrations, and hardware reboots were required for resolution. With operating room resource utilization valued between $30 and $100 per minute, this single technological latency resulted in a projected institutional deficit up to $3000 and needlessly prolonged patient anesthesia exposure. As robotic platforms become central to residency curricula, efficiency metrics must encompass technological orchestration alongside console time. We propose implementing a standardized Robotic Pre-Incision Synchronization Protocol for multi-disciplinary staff and urge manufacturers to design accelerated diagnostic interfaces to safeguard hospital financial reserves and optimize patient safety.<\/jats:p>","DOI":"10.1093\/jscr\/rjag878","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T19:26:58Z","timestamp":1789673218000},"source":"Crossref","is-referenced-by-count":0,"title":["The hidden costs of technical advancements: software and equipment troubleshooting in robotic inguinal hernia repair"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4580-055X","authenticated-orcid":false,"given":"Christian","family":"Martin","sequence":"first","affiliation":[{"name":"Department of Clinical Clerkships, Ross University School of Medicine , 2300 SW 145th Avenue, Miramar, FL 33027 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Howells","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Lexington Medical Center , 2720 Sunset Boulevard, West Columbia, SC 29169 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"2026092919194177200_ref1","first-page":"2318","article-title":"Economic analysis of the robotic approach to inguinal hernia repair (r-TAPP) vs laparoscopic approach (l-TAPP)","volume":"38","author":"K\u00f6ckerling","year":"2024","journal-title":"Surg Endosc"},{"key":"2026092919194177200_ref2","doi-asserted-by":"publisher","first-page":"e176233","DOI":"10.1001\/jamasurg.2017.6233","article-title":"Understanding costs of care in the operating room","volume":"153","author":"Childers","year":"2018","journal-title":"JAMA Surg"},{"key":"2026092919194177200_ref3","first-page":"117","article-title":"Initial trajectory and outcomes of a robotics program for inguinal hernia repair","volume":"19","author":"Zens","year":"2025","journal-title":"J Robot Surg"},{"key":"2026092919194177200_ref4","first-page":"4320","article-title":"Robotic inguinal hernia repair outcomes: operative time, cost, and learning curve","volume":"34","author":"Morrell","year":"2020","journal-title":"Surg Endosc"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/9\/rjag878\/71469093\/rjag878.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/9\/rjag878\/71469093\/rjag878.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T23:19:47Z","timestamp":1790723987000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjag878\/8845819"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,31]]},"references-count":4,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,8,31]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjag878","relation":{},"ISSN":["2042-8812"],"issn-type":[{"value":"2042-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,9]]},"published":{"date-parts":[[2026,8,31]]},"article-number":"rjag878"}}