Diastasis plication during robotic transabdominal preperitoneal repair (rTAPP): a case series of outcomes at a tertiary care center.

BACKGROUND

Despite increasing popularity, minimal data exist regarding diastasis plication during robotic ventral hernia repair for small defect sizes. We evaluated the safety and short-term efficacy of this procedure in a series of 30 patients at a tertiary care center using a single robotic technique.

METHODS

We performed a single-institution retrospective study of adult patients who underwent elective robotic ventral hernia repair and concomitant diastasis plication with mesh between 10/1/2020 and 12/31/2022. Patients were identified from the electronic medical record and clinical and operative data were manually abstracted from patient charts.

RESULTS

Thirty patients underwent robotic transabdominal preperitoneal repair and diastasis plication with mesh for hernia defects < 5 cm. Patient characteristics included mean age 50.6 ± 11.4 years, 50% female, BMI 32.5 ± 6.5 kg/m, 6.7% DMII, and 23.3% active smokers. Median operative time was 113.5 (IQR 97-147.5) minutes with 22% of patients undergoing a concurrent hernia repair (spigelian, inguinal, or multiple separate midline defects). Median hernia defect width was 3 ± 1.4 cm, median diastasis length was 10 ± 3.7 cm, and median mesh area was 64 ± 52.7 cm. No patients experienced surgical site infection, mesh infection, seroma, hematoma, or reoperation. Within 30 days, 3 patients were seen in the emergency department for superficial thrombophlebitis, reflux, and pain/emesis. There were no patients with clinical or radiographic recurrence at a mean postoperative follow-up of 116.0 ± 117.0 days.

CONCLUSIONS

Routine diastasis plication during robotic ventral hernia repair is safe and effective, with no increased rates of complications or adverse events and with no documented clinical or radiographic recurrence.