Background
Robotic procedures are increasingly being used in minimally invasive hernia surgery. A robotic program was initiated at our institution in 2018 and, consequently, robotic transabdominal preperitoneal repair (rTAPP) was offered to patients with inguinal hernias as an alternative to endoscopic totally extraperitoneal repair (TEP). We present short-term and 1‑year follow-up results for patients undergoing rTAPP compared to TEP for inguinal hernia repair.
Methods
Patients undergoing rTAPP or TEP operations were prospectively entered into the Herniamed registry. DaVinci robotic systems (Intuitive Surgical, Sunnyvale, CA, USA) were used for rTAPP. Macroporous nonabsorbable mesh was implanted in all operations. Perioperative parameters and follow-up data were recorded according to the standards of the Herniamed registry.
Results
From July 2017 until December 2021, 129 rTAPP and 571 TEP operations were entered into the database. Bilateral surgery was performed in 60 rTAPP operations vs. 206 TEP operations (p = 0.035). Operation time was significantly longer in rTAPP as compared to TEP, both for unilateral and bilateral hernias. Intra- and postoperative complication rates were low for both rTAPP and TEP, without significant differences. One-year follow-up was completed in 62 patients with unilateral rTAPP, 46 patients with bilateral rTAPP, 327 patients with unilateral TEP, and 180 patients with bilateral TEP. The recurrence rate after 1 year was 0% for unilateral rTAPP, 2.2% for bilateral rTAPP, 0.9% for unilateral TEP, and 2.8% for bilateral TEP.
Conclusion
Robotic TAPP is safe, and follow-up data after 1 year showed comparable results between the rTAPP and TEP techniques at our institution.
