Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2023 Feb;37(2):1188-1193.
doi: 10.1007/s00464-022-09614-y. Epub 2022 Sep 26.

Robotic versus laparoscopic transabdominal preperitoneal (TAPP) approaches to bilateral hernia repair: a multicenter retrospective study using propensity score matching analysis

Roberto Peltrini  1 , Francesco Corcione  2 , Daniela Pacella  2 , Simone Castiglioni  2 , Ruggero Lionetti  2 , Jacopo Andreuccetti  3 , Giusto Pignata  3 , Carlo De Nisco  4 , Luca Ferraro  5 , Adelona Salaj  5 , Giampaolo Formisano  5 , Paolo Pietro Bianchi  5 , Umberto Bracale  2
Affiliations
Multicenter Study

Robotic versus laparoscopic transabdominal preperitoneal (TAPP) approaches to bilateral hernia repair: a multicenter retrospective study using propensity score matching analysis

Roberto Peltrini et al. Surg Endosc. 2023 Feb.

Abstract

Background: Since the introduction of minimally invasive surgery, new techniques like transabdominal preperitoneal (TAPP) repair have progressively gained acceptance for the treatment of groin hernia. Laparoscopic TAPP (LTAPP) is recommended for bilateral repairs. Likewise, the introduction of robotic platforms has promised additional surgical benefits for robotic TAPP (RTAPP), which are yet to be confirmed. This study compared multicenter data obtained from patients undergoing bilateral inguinal hernia repair with RTAPP, performed during the preliminary learning curve period, versus conventional LTAPP.

Materials and methods: All consecutive bilateral inguinal hernia patients from four Italian centers between June 2015 and July 2020 were selected. A propensity score model was used to compare patients treated with LTAPP versus RTAPP, considering sex, age, body mass index, current smoking status, overall comorbidity, hernia classification (primary or recurrent), and associated procedures as covariates. After matching, intraoperative details and postoperative outcomes were evaluated.

Results: In total, 275 LTAPP and 40 RTAPP were performed. After matching, 80 and 40 patients were allocated to the LTAPP and RTAPP cohorts, respectively. No intraoperative complications or conversion to open surgery occurred. However, a longer operative time was recorded in the RTAPP group (79 ± 21 versus 98 ± 29 min; p < 0.001). Postoperative visual analog scale (VAS) pain scores (p = 0.13) did not differ and complication rates were similar. There were no clinical recurrences in either group, with mean follow-up periods of 52 ± 14 (LTAPP) and 35 ± 8 (RTAPP) months. A statistical difference in length of hospital stay was found between the groups (1.05 ± 0.22 vs 1.50 ± 0.74 days; p < 0.001).

Conclusion: In this patient population, outcomes for bilateral inguinal hernia repair appear comparable for RTAPP and LTAPP, except for a shorter recovery after laparoscopic surgery. A longer operative time for robotic surgery could be attributable to the learning curve period of each center.

Keywords: Bilateral hernia; Inguinal hernia; Laparoscopy; Outcomes; Robotic surgery; TAPP.

PubMed Disclaimer

Conflict of interest statement

Roberto Peltrini, Francesco Corcione, Daniela Pacella, Simone Castiglioni, Ruggero Lionetti, Jacopo Andreuccetti, Giusto Pignata, Carlo De Nisco, Luca Ferraro, Adelona Salaj, Giampaolo Formisano, Paolo Pietro Bianchi and Umberto Bracale have no conflict of interest or financial ties to disclosure.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Merola G, Cavallaro G, Iorio O, Frascio M, Pontecorvi E, Corcione F, Andreuccetti J, Pignata G, Stabilini C, Bracale U. Learning curve in open inguinal hernia repair: a quality improvement multicentre study about lichtenstein technique. Hernia. 2020;24(3):651–659. doi: 10.1007/s10029-019-02064-x. - DOI - PubMed
    1. Sodo M, Bracale U, Argentino G, Merola G, Russo R, Sannino G, Strazzullo T, Russo D. Simultaneous abdominal wall defect repair and tenckhoff catheter placement in candidates for peritoneal dialysis. J Nephrol. 2016;29(5):699–702. doi: 10.1007/s40620-015-0251-8. - DOI - PMC - PubMed
    1. HerniaSurge Group International guidelines for groin hernia management. Hernia. 2018;22(1):1–165. doi: 10.1007/s10029-017-1668-x. - DOI - PMC - PubMed
    1. Bracale U, Corcione F, Neola D, Castiglioni S, Cavallaro G, Stabilini C, Botteri E, Sodo M, Imperatore N, Peltrini R. Transversus abdominis release (TAR) for ventral hernia repair: open or robotic? Short-term outcomes from a systematic review with meta-analysis. Hernia. 2021;25(6):1471–1480. doi: 10.1007/s10029-021-02487-5. - DOI - PMC - PubMed
    1. Waite KE, Herman MA, Doyle PJ. Comparison of robotic versus laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair. J Robot Surg. 2016;10:239–244. doi: 10.1007/s11701-016-0580-1. - DOI - PubMed

Publication types

LinkOut - more resources