Jessica Gonzalez Hernandez, MD1, Purvi Prajapati, BS2, Gerald Ogola, PhD2, Ryan D Burkart, MD3, Lam D Le, MD3. 1UT Southwestern Medical Center, 2Baylor Scott and White Medical Center, 3Baylor University Medical Center
Introduction: The aim of this study was to report the perioperative morbidity and short-term outcomes of a case series of robotic-assisted laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repairs.
Methods and Procedures: A retrospective review (January through December 2015) of 104 patients who underwent either unilateral or bilateral robotic-assisted laparoscopic TAPP inguinal herniorrhaphy by two attending surgeons was performed. Patient demographics, perioperative morbidity, operative time, and follow-up data were analyzed.
Results: Patient demographics are summarized in Table 1. Mean operative times for unilateral and bilateral inguinal herniorrhaphy were 87.5±20.8 and 129.0±37.6 minutes, respectively. Mean robot console times for unilateral and bilateral inguinal herniorrhaphy were 70.0±25.1 and 113.0±39.8 minutes, respectively. Postoperative complications included urinary retention (6.7%), conversion to open repair (1%), and delayed reoperation (1.9%). No major bleeding, surgical site infection (SSI), or mortality was observed. At first follow-up visit (19±6 days), symptoms/signs included groin/scrotal swelling (8%), seroma (7%), groin pain (3%), burning (3%), numbness (1%), and persistent urinary retention (1%). 12% of patients required a second follow-up visit. Two patients underwent reoperation for suspected recurrence but instead a cord lipoma was found without a hernia defect.
Conclusions: Robotic-assisted TAPP inguinal herniorrhaphy can be performed with operative times and short-term outcomes similar to those published for open technique. The robotic-assisted TAPP inguinal herniorrhaphy is a safe and an efficient minimally invasive surgical option with lower SSI risk and better cosmetic results.
Table 1. Patient Demographics and Intraoperative Data
|
Parameters |
Unilateral (n=51) |
Bilateral (n=53) |
Overall (n=104) |
|---|---|---|---|
|
Age, years |
54±15 |
54±14 |
54±14 |
|
Male, % |
94.1 |
98.1 |
96.2 |
|
Body mass index, kg/m2 |
29.5±4.9 |
27.3±4.5 |
28.4±4.8 |
|
Previous abdominal surgery, % |
23.5 |
32.1 |
27.9 |
|
Recurrent inguinal hernia, % |
1.9 |
13.7 |
7.7 |
|
Operative time, min |
87.5±20.8 |
129.0±37.6 |
109.1±37.0 |
|
Console time, min |
70.0±25.1 |
113.0±39.8 |
91.0±39.4 |
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86544
Program Number: P779
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster