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Introduction of Robotic Transabdominal Pre-Peritoneal (R-TAPP) Repair for Elective Groin Hernias: A Single Centre Experience

Shashank Iyer

Shashank Iyer, Kayleigh Spellar, Alex Laurie, David Bunting
North Devon District Hospital - Royal Devon University Healthcare NHS Trust, Barnstaple, United Kingdom

Abstract

Introduction

Robotic surgery has emerged as a novel approach to minimally invasive hernia repair. There is a need to evaluate the day case applicability and safety of the robotic technique. This study aims to compare day case and complication rates for patients undergoing elective inguinal/femoral hernia repair using the Da Vinciā„¢ XI robotic platform, laparoscopic technique and open procedures at our facility.

Methods

A retrospective review of electronic records was conducted to identify all patients undergoing elective inguinal/femoral hernia repair between January and December 2023. Patients were divided into robotic, laparoscopic, or open groups depending on the surgical technique. Day case rates and 30-day complications were recorded for each group and compared.

Results

During the data collection period, 269 patients underwent elective groin hernia repair, of which 53 were robotic, 61 were laparoscopic and 155 were open. Day case rates were 89%, 84% and 83% in the robotic, laparoscopic, and open groups respectively. The overall day case rate was 84%, which approaches the BADS benchmark target of 90%. There were 46 complications overall (17.1%). Complication rates were 13% for robotic repair, 13% for laparoscopic repair and 20% for open repair. Among robotic complications, the most common was hematoma. All robotic complications were managed conservatively.

Conclusions

Our study indicates that at this stage, the complication rates following robotically assisted groin hernia repair are equivalent to those in laparoscopic repair and lower than those in open repair. Further data are required with a larger sample size to evaluate long-term outcomes.