Summary of ‘Long‑term outcomes of robotic inguinal hernia repair (r‑TAPP): a retrospective review of 434 consecutive cases by a single surgeon with 3–8 years of follow‑up’
The article presents a comprehensive retrospective review of long-term outcomes associated with robotic-assisted transabdominal preperitoneal (r-TAPP) repair of inguinal hernias, conducted by a single surgeon over a span of 3 to 8 years. The study involved a total of 434 consecutive r-TAPP procedures performed on 324 patients, with surgeries conducted between April 2016 and February 2021. The primary objective was to address the limited literature on long-term outcomes of r-TAPP procedures, as most previous studies have focused on smaller cohorts with shorter follow-up durations.
Demographics and Procedures
Among the 324 patients studied, there was an equal distribution of left-sided and right-sided inguinal hernias, each accounting for 33% of cases, while bilateral hernias represented approximately 33.95%. The patient ages varied significantly, ranging from 25 to 96 years, with a mean Body Mass Index (BMI) of 26.9. The total procedure times varied between 35 to 191 minutes, with an average of 62 minutes. Notably, none of the patients experienced major complications such as significant blood loss or the need for conversion to open surgery, and all patients were discharged on the same day as the procedure.
Follow-Up and Outcomes
The follow-up rates for the patients were impressively high, with 86.9% of patients being followed up at the 3-year mark, and similar rates were maintained until the 8-year follow-up. Remarkably, only two cases of hernia recurrence were reported, resulting in a low recurrence rate of 0.46%. Furthermore, no patients reported experiencing chronic pain between 3 to 8 years post-operation. The outcomes of the r-TAPP procedure demonstrate not only its effectiveness in securing inguinal hernia repairs but also its ability to minimize postoperative complications and promote patient recovery.
Comparison to Other Surgical Techniques
When comparing the r-TAPP procedure to traditional laparoscopic and open repair techniques, the study found that while the median operative time for laparoscopic repairs is approximately 79 minutes, r-TAPP procedures demonstrated comparable or even shorter times, with averages of 54 minutes for left-lateral hernias and 53 minutes for right-lateral hernias. Although the r-TAPP approach may have longer times than open repair (44 minutes), it offers superior precision and outcomes, establishing it as a valuable option for inguinal hernia repairs.
Historical Context and Future Implications
Inguinal hernias have a long history, with surgical techniques evolving significantly over time. The development of minimally invasive techniques, including laparoscopic and robotic surgeries, has led to advancements in patient care and recovery. The r-TAPP procedure, backed by this study’s findings, presents a promising option for inguinal hernia repair, particularly in complex cases. The authors argue for the implementation of robotic-assisted hernia repair programs in healthcare institutions, highlighting the potential for enhanced surgical precision, improved patient safety, and better long-term outcomes.
Conclusion
The findings of this study underscore the reliability and efficiency of the r-TAPP repair method for inguinal hernias. With its demonstrated low recurrence rate and favourable patient outcomes, the r-TAPP procedure offers a compelling option for outpatient surgical treatment of inguinal hernias. The study contributes significantly to the existing literature by providing long-term data and advocating for broader adoption of robotic-assisted techniques in surgical practice, ultimately aiming to enhance patient care in the field of hernia repair.
READ MORE… https://link.springer.com/article/10.1007/s11701-025-02220-9
