Safety and feasibility of emergency robot‐assisted transabdominal preperitoneal repair for the treatment of incarcerated inguinal hernia: A retrospective study

Abstract

BackgroundFew studies assessed robotic in emergency setting and no solid evidence was demonstrated. The aim of this study was to evaluate the feasibility and safety of robot‐assisted transabdominal preperitoneal (R‐TAPP) repair for the treatment of incarcerated inguinal hernia.MethodsWe retrospectively searched from a prospectively maintained database patients who underwent R‐TAPP or open surgery for incarcerated inguinal hernias from January 2018 to March 2023. The primary endpoint was to assess safety and feasibility of the R‐TAPP compared to the standard approach. For eligible patients, data was extracted and analyzed using a propensity score‐matching (PSM).ResultsThirty‐four patients were retrieved from our database, 15 underwent R‐TAPP, while 19 underwent open surgery. Mean age was 73.1 ± 14.6 years, 30 patients (88.2%) were male and mean BMI was 23.5 ± 3.2 kg/m2. No intraoperative complication occurred. Three cases requiring small bowel resection were all in the open surgery group (p = 0.112). The operative time was 108 ± 31 min versus 112 ± 31 min in the R‐TAPP and open surgery groups (p = 0.716). Seven postoperative complications occurred, only one classified as severe was in the open surgery group. The length of hospital stay was 2.9 ± 1.8 in the R‐TAPP versus 4.2 ± 2.3 min in the open surgery group (p = 0.077). PSM analysis showed similar postoperative outcomes and costs in both groups.ConclusionsDespite its limitations, our study appears to endorse the safety and feasibility of the robotic‐assisted treatment for incarcerated inguinal hernia. This approach yielded comparable results to open surgery, albeit in a limited number of patients, suggesting it might be a viable alternative.