P-059 ROBOT ASSISTED TRANS ABDOMINAL PRE-PERITONEAL (RTAPP) MESHPLASTY FOR GIANT GROIN HERNIAS - OUR HYBRID ROBOTIC SURGERY CHOREOGRAPHY FOR OPTIMIZING OUTCOMES

Abstract

Abstract Aim To demonstrate our successful, cost effective & time saving choreography for managing Large Groin Hernia with Robot assisted Trans Abdominal Pre-Peritoneal (rTAPP) Meshplasty Surgery Materials & Methods 7 patients with Groin Hernia EHS Classification P/R M/L 3 were operated using Da Vinci Xi Robotic platform and underwent TAPP Meshplasty between October 2021 & June 2022. We noted the instruments used(Robotic and Laparoscopic), the Surgery duration & Console Time, the ease of the surgery & the Choreography, Intra-operative challenges, intra-operative change in surgical steps, post-op pain scores, analgesia usage & outcomes. Results Laparoscopic instruments were used in 7/7 (100%) patients for accomplishing various steps. Both flat & 3D Anatomically contoured meshs were used. Usage of Laparoscopic Instruments at various steps & in tandem with Robotic instruments optimizes the cost of the surgery, helps in decreasing surgical duration & utilization of resources. The trends evolve as one negotiates the learning curve. Conclusions Our study demonstrated that for Large Groin Hernia it is recommended to include Laparoscopic instruments during Robot assisted surgery along with specific surgical steps for successful completion of rTAPP in a cost-effective manner.