A single-center retrospective review of laparoscopic totally extraperitoneal versus robotic transabdominal preperitoneal inguinal hernia repair

Abstract

Background With the increased use of robotic surgery, robotic transabdominal preperitoneal repair (R-TAPP) has become a commonly used approach for inguinal hernia repair. The laparoscopic totally extraperitoneal repair (L-TEP) has the advantage of not entering the peritoneal cavity; however, it has greater technical difficulty. Robotic surgery has demonstrated superiority over laparoscopy in many surgical settings, but there is limited evidence comparing L-TEP and R-TAPP. Methods This was a retrospective review of patients who underwent L-TEP and R-TAPP at Baylor University Medical Center between December 2011 and January 2022. Information on patient demographic characteristics, comorbidities, postoperative complications, hospital length of stay, and postoperative complications requiring a procedure was collected. Results A total of 298 patients were analyzed; 245 underwent R-TAPP and 53 underwent L-TEP. Hernia recurrence was significantly decreased in those who underwent R-TAPP (1.2%) compared to L-TEP (9.4%) (P = 0.01). Postoperative pain was also significantly decreased in the R-TAPP group (5.3%) as compared to the L-TEP group (13.2%) (P = 0.01). Conclusions With the transition from L-TEP to R-TAPP over recent years, there is limited evidence supporting this change in practice. Our single-center retrospective review demonstrates that R-TAPP is noninferior to L-TEP and has significantly decreased hernia recurrence.