Jung Sungwoo, Lee Jin Ho, Lee Hyung Soon
Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
J Minim Invasive Surg. 2023 Sep 15;26(3):128-133. doi: 10.7602/jmis.2023.26.3.128.
Robotic hernia repair has increased in popularity since the introduction of da Vinci robots (Intuitive Surgical). However, we lack quantitative analyses of its potential benefits. Herein, we report our initial experience with robotic transabdominal preperitoneal (R-TAPP) inguinal hernia repair.
We retrospectively reviewed the data from patients who underwent R-TAPP inguinal hernia repair with a prosthetic mesh using the da Vinci platform. Data on patient characteristics and surgical outcomes were also collected.
Twenty-one patients (including 20 male patients [95.2%]) with a mean age of 54.1 ±16.4 years and body mass index of 23.8 ± 1.9 kg/m underwent R-TAPP inguinal hernia repair. Bilateral hernia repair was performed in two patients (9.5%), and six patients (28.5%) with scrotal hernia underwent R-TAPP hernia repair. A sigmoid colon sliding hernia was present in three patients (14.3%). The mean operation and console times were 91.8 ± 20.4 minutes and 154.5 ± 26.2 minutes, and 61.4 ± 16.9 minutes and 128.0 ± 25.5 minutes for unilateral and bilateral inguinal hernia, respectively. Spermatic vessel injury was identified intraoperatively in one patient. Two minor postoperative complications, postoperative ileus, and wound seroma were reported. The mean duration of hospitalization was 3.8 ± 0.9 days. No recurrence or conversion to open surgery was required.
Our findings suggest that R-TAPP inguinal hernia repair is safe and feasible. Its cost-effectiveness, optimal procedural steps, and indications for a robotic approach require further investigation.
自达芬奇机器人(直观外科公司)引入以来,机器人疝气修补术越来越受欢迎。然而,我们缺乏对其潜在益处的定量分析。在此,我们报告我们在机器人经腹腹膜前(R-TAPP)腹股沟疝修补术中的初步经验。
我们回顾性分析了使用达芬奇平台接受R-TAPP腹股沟疝修补术并使用人工补片的患者数据。还收集了患者特征和手术结果的数据。
21例患者(包括20例男性患者[95.2%])接受了R-TAPP腹股沟疝修补术,平均年龄为54.1±16.4岁,体重指数为23.8±1.9kg/m²。2例患者(9.5%)进行了双侧疝修补,6例阴囊疝患者(28.5%)接受了R-TAPP疝修补。3例患者(14.3%)存在乙状结肠滑动疝。单侧和双侧腹股沟疝的平均手术时间和控制台操作时间分别为91.8±20.4分钟和154.5±26.2分钟,以及61.4±16.9分钟和128.0±25.5分钟。术中发现1例患者精索血管损伤。报告了2例轻微术后并发症,即术后肠梗阻和伤口血清肿。平均住院时间为3.8±0.9天。无需复发或转为开放手术。
我们的研究结果表明,R-TAPP腹股沟疝修补术是安全可行的。其成本效益、最佳手术步骤以及机器人手术方法的适应症需要进一步研究。