Format

Send to

Choose Destination
Surg Endosc. 2018 Dec;32(12):4850-4859. doi: 10.1007/s00464-018-6236-7. Epub 2018 May 15.

Robotic-assisted laparoscopic groin hernia repair: observational case-control study on the operative time during the learning curve.

Author information

1
Department of Surgery, Maria Middelares, Buitenring Sint-Denijs 30, 9800, Ghent, Belgium. filip.muysoms@azmmsj.be.
2
Department of Surgery, Maria Middelares, Buitenring Sint-Denijs 30, 9800, Ghent, Belgium.
3
Center for Minimally Invasive and Robotic Surgery, Phoenix, AZ, USA.
4
Department of Surgery, Minneapolis VA Medical Center, University of Minnesota, Minneapolis, MN, USA.

Abstract

BACKGROUND:

Robotic groin hernia repair (r-TAPP) is demonstrating rapid adoption in the US. Barriers in Europe include: low availability of robotic systems to general surgeons, cost of robotic instruments, and the perception of longer operative time.

METHODS:

Patients undergoing r-TAPP in our start-up period were prospectively entered in the EuraHS database and compared to laparoscopic TAPP (l-TAPP) performed by the same surgeon within the context of two other prospective studies. Operations were performed with the daVinci Xi robot and the primary endpoint was skin-to-skin operative time.

RESULTS:

Following proctoring in September 2016 by US surgeons, 50 r-TAPP (34 unilateral and 16 bilateral) procedures have been performed up to January 2017. Mean operative time for unilateral r-TAPP was 54 min, with a decrease from 63 min for the first tertile to 44 min for the third tertile. For unilateral l-TAPP, the mean operative time was 45 min. Mean operative time for bilateral r-TAPP was 78 min, with a decrease from 90 min for the first half to 68 min for the second half. For bilateral l-TAPP, the mean operative time was 61 min. There were no intraoperative complications and no conversions to conventional laparoscopy or open surgery. The operation was performed as an outpatient in 67% of cases. Urinary retention requiring urinary catheterization was the only early postoperative complication noted in 5 patients (10.2%). At 4 week follow-up, 7 patients (14.3%) had an asymptomatic seroma, but no other complications were seen.

CONCLUSION:

Robotic TAPP was associated with a rapid reduction in operative time during our learning curve and afterwards the operative time to perform a robotic TAPP equals the operative time to perform a laparoscopic TAPP, both for unilateral and for bilateral groin hernia repairs. No complications related to the introduction of robotic-assisted laparoscopic groin hernia repair were observed.

KEYWORDS:

Groin hernia; Inguinal hernia; Laparoscopy; Learning curve; Operative time; Robotic surgery

PMID:
29766308
DOI:
10.1007/s00464-018-6236-7

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center