Comparison of short-term outcomes of robotic and laparoscopic transabdominal peritoneal repair for unilateral inguinal hernia: a propensity-score matched analysis

Okamoto, Nariaki; Mineta, Sho; Mishima, Kazuo; Fujiyama, Y; Wakabayashi, T; Fujita, S; Sakamoto, J; Wakabayashi, Go

doi:10.1007/s10029-022-02730-7

Cited by 7 publications

(15 citation statements)

References 22 publications

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“…[17][18][19] In Japan, R-TAPP has been performed as a self-paid medical treatment since its introduction at Ageo Central General Hospital in 2016. 11 At present, the number of hospitals performing the procedure and number of R-TAPPs performed are limited. Therefore, we conducted a nationwide retrospective study following the initial introduction of R-TAPP.…”

Section: Discussionmentioning

confidence: 99%

“…Since its introduction in the United States in 2007, R‐TAPP has experienced explosive growth; however, only few nationwide surveys on its performance have been reported (Table 7). 17–19 In Japan, R‐TAPP has been performed as a self‐paid medical treatment since its introduction at Ageo Central General Hospital in 2016 11 . At present, the number of hospitals performing the procedure and number of R‐TAPPs performed are limited.…”

Section: Discussionmentioning

confidence: 99%

“…12 Okamoto et al compared unilateral inguinal hernia surgery in 80 cases of R-TAPP and L-TAPP by propensity score matching and reported there were no differences in operative time, post-operative hospital stay, pain, recurrence, or complications; in addition, the dissection time tended to be short, especially in medial inguinal hernia cases, and the learning curve of surgery reached a plateau in 7-10 cases. 11 In the present study, we retrospectively analyzed the data of R-TAPP cases from 12 pioneering hospitals in Japan and examined the safety of the procedure, short-term post-operative outcomes, and learning curve.…”

Section: Introductionmentioning

confidence: 99%

“…Approximately half of these are laparoscopic procedures; however, R‐TAPP is currently performed as self‐pay care under Japan's unique insurance system. In 2016, the first R‐TAPP surgery was performed in Japan at Ageo Central General Hospital; 11 subsequently, it has gradually spread to other hospitals as self‐pay care. Saito et al designed a surgical protocol for the safe introduction of R‐TAPP and reported its initial results 12 .…”

Section: Introductionmentioning

confidence: 99%

“…Saito et al designed a surgical protocol for the safe introduction of R‐TAPP and reported its initial results 12 . Okamoto et al compared unilateral inguinal hernia surgery in 80 cases of R‐TAPP and L‐TAPP by propensity score matching and reported there were no differences in operative time, post‐operative hospital stay, pain, recurrence, or complications; in addition, the dissection time tended to be short, especially in medial inguinal hernia cases, and the learning curve of surgery reached a plateau in 7–10 cases 11 …”

Section: Introductionmentioning

confidence: 99%

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Safety and short‐term outcomes of robotic‐assisted transabdominal preperitoneal repair for inguinal hernia in pioneering hospitals in Japan: A nationwide retrospective cohort study

Okamoto,

Misawa,

Shimada

et al. 2023

Asian J Endoscop Surgery

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IntroductionWe aimed to evaluate the safety and short‐term outcomes of robotic‐assisted transabdominal preperitoneal repair for inguinal hernia in 12 pioneering hospitals in Japan.MethodsClinical data of patients who underwent robotic‐assisted transabdominal preperitoneal repair between September 1, 2016, and December 31, 2021 were collected. Primary outcome measures were intra‐operative adverse events and post‐operative complications, whereas secondary outcomes were surgical outcomes, including chronic pain, recurrence, and learning curve.ResultsIn total, 307 patients were included. One case of inferior epigastric arterial injury was reported; no cases of bowel or bladder injury were reported. Thirty‐five seromas were observed, including four (1.3%) cases that required aspiration. The median operative time of a unilateral case was 108 minutes (interquartile range: 89.8–125.5), and post‐operative pain was rated 1 (interquartile range: 0–2) on the numerical rating scale. In complicated cases, such as recurrent inguinal hernias and robotic‐assisted radical prostatectomy‐associated hernias, dissection and suture were safely achieved, and no complications were observed, except for non‐symptomatic seroma. All patients underwent robotic procedures, and there was no chronic post‐operative inguinal pain, although one case of hernia recurrence was reported. Regarding the learning curve, plateau performance was achieved after 7–10 cases in terms of operative time (P < .001).ConclusionRobotic‐assisted transabdominal preperitoneal repair can be safely introduced in Japan. Regardless of the involvement of many surgeons, the mastery of robotic techniques was achieved relatively quickly. The advantage of robotic technology such as wristed instruments may expand the application of minimally invasive hernia repair for complicated cases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Safety and short‐term outcomes of robotic‐assisted transabdominal preperitoneal repair for inguinal hernia in pioneering hospitals in Japan: A nationwide retrospective cohort study

Okamoto,

Misawa,

Shimada

et al. 2023

Asian J Endoscop Surgery

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Single-port versus multi-port laparoscopic and robotic inguinal hernia repair: a systematic review and network meta-analysis

Thanawiboonchai,

Cyntia Lima Fonseca Rodrigues,

Zevallos

et al. 2024

Surg Endosc

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Robotic minimally invasive inguinal hernia repair with the Dexter robotic system™: A prospective multicenter clinical investigation

Gantner,

Mignot,

Pochhammer

et al. 2024

Surg Endosc

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Background Robot-assisted transabdominal preperitoneal inguinal hernia repair (rTAPP) has been established with various robotic platforms. The Dexter robotic system is an open platform consisting of a sterile surgeon’s console, two robotic instrument arms, and one robotic endoscope arm. This study aimed to confirm the perioperative and early postoperative safety and clinical performance of the Dexter system in patients undergoing primary transperitoneal inguinal hernia repair. Methods The primary objectives of this multicenter study conducted at three centers in France, Germany, and Switzerland were to document the successful completion of rTAPP procedures and the occurrence of serious adverse events (Clavien–Dindo grades III–V), device-related events up to 30 days post-surgery. The procedures were performed by three surgeons with varying levels of experience in robotic systems. Results 50 patients with a median age of 62.5 years (IQR 51.0–72.0) and BMI of 25.1 kg/cm2 (IQR 23.5–28.7), respectively, underwent inguinal hernia repair (33 unilateral, 17 bilateral). All surgeries were successfully completed using three standard laparoscopy trocars. There were no conversions to open surgery, intraoperative complications or device deficiencies. The median skin-to-skin operative time was 50 min (IQR 45–60) for unilateral hernias and 96 min (IQR 84–105) for bilateral hernias. The median console time was 30 min (IQR 26–41) for unilateral and 66 min (IQR 60–77) for bilateral hernias. Twenty-six patients were discharged on the day of surgery, and 22 on postoperative day 1. Conclusion This study confirmed the use of the Dexter system in rTAPP was feasible and safe in multicenter cohorts, with operative times consistent with the literature on other robotic platforms. Our data demonstrated the accessibility of this new robotic approach, even when adopted by surgeons new to robotics. The Dexter system emerged as a valuable device in the hernia repair toolkit for both experienced robotic surgeons and those new to the field.

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Comparison of short-term outcomes of robotic and laparoscopic transabdominal peritoneal repair for unilateral inguinal hernia: a propensity-score matched analysis

Cited by 7 publications

References 22 publications

Safety and short‐term outcomes of robotic‐assisted transabdominal preperitoneal repair for inguinal hernia in pioneering hospitals in Japan: A nationwide retrospective cohort study

Safety and short‐term outcomes of robotic‐assisted transabdominal preperitoneal repair for inguinal hernia in pioneering hospitals in Japan: A nationwide retrospective cohort study

Single-port versus multi-port laparoscopic and robotic inguinal hernia repair: a systematic review and network meta-analysis

Robotic minimally invasive inguinal hernia repair with the Dexter robotic system™: A prospective multicenter clinical investigation

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