A Retrospective Review of a Large Series of Groin Hernia Patients Operated with Robotically Assisted Laparoscopic Technique (R-TAPP)

We have reviewed the patient outcome and the feasibility of robotically assisted inguinal hernia repair (R-TAPP) from the first 4-years period after its introduction in our department in a Scandinavian Public Health hospital. A total of 226 hernia repairs were performed in 195 patients (31 bilateral hernias). 160 patients had primary hernias, whereas 35 had recurrent hernias. Of the recurrent hernias, three had recurred twice. The majority of the hernias were in the right groin (53.3%) and the lateral location was the most common (65.0%). The hernia was scrotal in 29 cases. The mean operation time was significantly reduced throughout the observation period for our cohort, i.e. from 81 to 57 min (p < 0.001). The operation time was 27 min faster (mean value) in unilateral vs bilateral hernias and 19 min faster (mean value) in primary vs residual hernias. There were no statistically significant differences in operation time between lateral and medial hernias, and no differences in operation time between the obese and normal-weight cases. We experienced four severe per-operative complications (4/226; 1.8%): two cases of abdominal wall bleeding subsequently undergoing intravascular coiling, one perforation of the urinary bladder and one perforation of small bowel that were both closed by direct suture intraoperatively. There were no conversions to laparoscopy or open procedure. One hernia recurred during the observation period. Our findings suggest that the R-TAPP procedure in a Scandinavian Public Health hospital's surgical department is both safe and feasible.