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. 2023 Mar;37(3):2003-2013.
doi: 10.1007/s00464-022-09737-2. Epub 2022 Oct 25.

Robotic inguinal hernia repair: is the new Da Vinci single port platform providing any benefit?

Nicolas H Dreifuss  1 , Betty Chang  2 , Francisco Schlottmann  2 , Antonio Cubisino  2 , Alberto Mangano  2 , Mario A Masrur  2 , Francesco M Bianco  2
Affiliations

Robotic inguinal hernia repair: is the new Da Vinci single port platform providing any benefit?

Nicolas H Dreifuss et al. Surg Endosc. 2023 Mar.

Abstract

Background: The utilization of the robot for inguinal hernia repairs has increased in the past years. The new Da Vinci Single Port (SP) system provides the benefits of single-incision procedures and might overcome the technical difficulties of previous single-incision techniques. The aim of this study was to evaluate the safety and feasibility of the SP transabdominal preperitoneal inguinal hernia repair (SP-TAPP) and compare its outcomes to the robotic multiport technique (MP-TAPP).

Methods: A prospective cohort of patients who underwent a robotic SP-TAPP and MP-TAPP between 2012 and 2022 was analyzed. Primary endpoints were same-day discharge, morbidity, and inguinal recurrence rates. Secondary endpoints included conversion, operative time, port-site incisional hernia, and chronic pain.

Results: MP-TAPP and SP-TAPP were performed in 378 (81.3%) and 87 (18.7%) patients, respectively. Demographics were similar between groups. There were no conversions or intraoperative complications. Mean operative (MP-TAPP: 93.2 vs. SP-TAPP: 78.1 min, p = 0.003) and recovery time (MP-TAPP: 160.8 vs SP-TAPP: 112.6 min, p < 0.001) were significantly shorter in the SP group. Same-day discharge rate was higher (MP-TAPP: 86.5% vs. SP-TAPP: 97.7%, p = 0.001) after SP-TAPP; 30-day morbidity, readmissions, and chronic pain rates were similar between groups. After a mean follow-up of 30.6 months for MP-TAPP and 13.3 months for SP-TAPP, inguinal hernia recurrence and port-site incisional rates were similar between groups.

Conclusion: Robotic SP-TAPP is safe and feasible. When compared to MP-TAPP, it showed similar postoperative morbidity, higher same-day discharge rates, and a quicker postoperative recovery. Further studies are needed to confirm the benefits of the SP platform.

Keywords: Da Vinci SP; Inguinal hernia; Robotic single port; Robotic surgery; Single-incision surgery; TAPP.

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