P072 articulated Laparoscopic Instruments. Benefits on Laparoscopic Hernioplasty

Abstract

Aim To present initial experience using 5 mm articulated laparoscopic instruments in tapp laparoscopic hernioplasty that emulated the benefits attributed to robotic surgery. Material and Methods We report data from the first 42 procedures using 5 mm articulating instruments. A retrospective analysis was performed in patients who underwent tapp laparoscopic hernioplasty using novel articulated graspers, needle holders, and scissors. The surgeons and surgical nurses were trained in the handling and operation of the articulating instruments, before the first surgical procedure. In all cases, articulating instruments were inserted through 5 mm trocars. Data collected included patient demographics, details related to the surgical procedure, postoperative outcomes, and complications. Results Over a period of one month, were repaired 78 inguinal hernias. 36 patients had a bilateral hernia, and the mean age was 45 years (SD 15.1), with a mean BMI of 28.6 (SD 6.1). 32 male and 4 female patients. The mean operative time was 90 min. The articulated head of the clamp allowed traction, dissection, and suture in different directions. In addition, was not detected a significant learning curve due to its intuitive applicability. Surgical complications included two serohematomas. All patients discharge during operation day. The procedures performing without intraoperative complications nor conversion to open surgery occurred. Conclusions The use of an articulated instrument has a promising future. It would meet some benefits of robotics without increasing costs. We need randomized comparative studies for a better conclusion.