Robotic-assisted laparoscopic groin hernia repair: observational case-control study on the operative time during the learning curve

Muysoms, Filip; Cleven, Stijn Van; Kyle-Leinhase, I.; Ballecer, Conrad; Ramaswamy, Archana

doi:10.1007/s00464-018-6236-7

Cited by 67 publications

(69 citation statements)

References 15 publications

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“…The plateau of the LC for both laparoscopic TAPP and TEP procedures varies between 13 and 65 cases. 6,[14][15][16][17] The European Hernia Society guidelines state that the TAPP and totally extra peritoneal inguinal hernia repair LCs peak after experiencing 50-100 cases, with the first 30-50 cases having the highest incidence of complications. 18 Bansal et al reported that the average number for stabilization of the LC was 13 operations for laparoscopic TEP and TAPP.…”

Section: Discussionmentioning

confidence: 99%

Learning curve analysis of robotic transabdominal preperitoneal inguinal hernia repair

Aghayeva

Aytaç

Dinç

et al. 2020

Robotics Computer Surgery

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Background: The purpose of this study was to assess the learning curve (LC) for inguinal hernia repair with robotic transabdominal preperitoneal (R-TAPP) approach. Methods: Between April 2016 and October 2019, patients who underwent R-TAPP were retrieved. Patient demographics, operative variables and postoperative outcomes were assessed. The moving average method and cumulative sum of operation times (OT) were used to evaluate the LC. The surgeon (BB) in this study had completed his laparoscopic (Lap) TAPP experience. Results: There were 50 (two females) consecutive patients (mean age was 51.7 � 16.9 years). The first phase (learning phase) included initial 35 operations. The second phase included the next 15 operations. It was observed that, with increasing experience, a statistically significant shortening in the average OT by about 25 min was achieved (p ¼ 0.041). Conclusion: The LC phase for R-TAPP, for surgeon with previous experience in Lap TAPP, seems to be very quick without compromising the operative morbidity.

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Section: Discussionmentioning

confidence: 99%

Learning curve analysis of robotic transabdominal preperitoneal inguinal hernia repair

Aghayeva

Aytaç

Dinç

et al. 2020

Robotics Computer Surgery

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“…In this setting, simultaneous repair of groin hernia can always be repaired quickly and easily. Therefore, groin hernia repair has rapidly gained popularity in the past decade, especially during a robot‐assisted radical prostatectomy, which potentially increases the incidence of groin hernias after surgery . However, whether we really need a surgical robot just for repairing a simple groin hernia is still questionable due to its higher cost, longer operative time, and uncertainty about its clinical benefits …”

Section: Discussionmentioning

confidence: 99%

“…Laparoscopic groin hernia repairs are commonly carried out via two standard approaches, either trans‐abdominal pre‐peritoneal (TAPP) repair or total extra‐peritoneal (TEP) repair. In the robotic era, most of the reported robot‐assisted techniques were performed using the TAPP approach, except in very limited case reports of simultaneous TEP repair during a robot‐assisted radical prostatectomy . Although these two standardized laparoscopic approaches for groin hernia repair are comparable in their long‐term clinical outcomes, the TAPP approach was associated with more surgical complications and seroma formation than was the TEP approach in a large‐scale population‐based study …”

Section: Introductionmentioning

confidence: 99%

Novel robot‐assisted laparoscopic total extra‐peritoneal repair with primary fascial closure plus pre‐peritonea mesh for large groin defects

Chen

et al. 2019

Robotics Computer Surgery

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Background:Since the introduction of robot-assisted laparoscopic surgery, a variety of conventional laparoscopic procedures have been explored via this approach. In the robotic era, most of the reported robot-assisted laparoscopic hernia repairs were performed with the trans-abdominal pre-peritoneal approach.According to the evidence extrapolated from laparoscopic ventral hernia repair, simultaneous fascial defect closure and mesh repair can significantly decrease the risk of seroma formation and recurrence over those without fascial closure.Therefore, we describe our novel technique of robot-assisted total extraperitoneal (TEP) repair with primary fascial closure and pre-peritoneal mesh and its preliminary clinical outcomes. Methods: We retrospectively reviewed our prospectively collected hernia database from October 2017 to July 2019, which included 26 consecutive patients with primary or recurrent groin hernias. Patients' baseline characteristics and perioperative outcomes were compared and analyzed. Perioperative factors included operative time, visual analog scale (VAS) score (0-100), hospital stay, perioperative complications, time to return to normal activity, and the modified Medical Outcome Study (MOS; item 3-12/36 items) score. Results: All procedures were completed successfully without conversion to open or conventional laparoscopic surgery. The patients' age ranged from 28 to 74 years (median 57.5). The mean operative time was 115 minutes (range 95-172 min). There were no major procedure-related complications. Only four cases experienced asymptomatic seromas, which were detected by ultrasonography; and all resolved spontaneously within 6 weeks after the operation. The VAS and modified MOSs revealed quick recovery after robot-assisted endoscopic TEP repair.Conclusions: Robot-assisted endoscopic TEP repair combined with primary fascial closure and pre-peritoneal mesh is a safe and feasible technique for groin hernia repair.

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“…Recently minimally invasive surgery (MIS) for inguinal hernia repair has become the procedure of choice for surgeons that previously favored an open anterior approach [8]. They are utilizing a robotic transabdominal pre-peritoneal approach (TAPP) instead of a pure laparoscopic approach [9,10].…”

mentioning

confidence: 99%

“…Previously surgeons had to learn the anatomy of the posterior approach and the details of the repair as well as had to master the laparoscopic skills required to safely complete the repair. For many surgeons the robotic platform has made this much easier and has initiated the recent rapid growth in MIS inguinal hernia repair [8][9][10].…”

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confidence: 99%

Ten golden rules for a safe MIS inguinal hernia repair using a new anatomical concept as a guide

et al. 2020

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Background Although laparoscopic inguinal hernia repair was described about 30 years ago and advantages of the technique have been demonstrated, the utilization of this approach has not been what we would expect. Some reasons may be the need for surgeons to understand the posterior anatomy of the groin from a new vantage point, as well as to acquire advanced laparoscopic skills. Recently, however, the introduction of a robotic approach has dramatically increased the adoption of minimally invasive techniques for inguinal hernia repair. Methods Important recent contributions to this evolution have been the establishment of a new concept known as the critical view of the Myopectineal Orifice (MPO) and the description of a new way of understanding the posterior view of the antomy of the groin (inverted Y and the five triangles). In this paper, we describe 10 rules for a safe MIS inguinal hernia repair (TAPP, TEP, ETEP, RTAPP) that combines these two new concepts in a unique way. Conclusions As the critical view of safety has made laparoscopic cholecystectomy safer, we feel that following our ten rules based on understanding the anatomy of the posterior groin as defined by zones and essential triangles and the technical steps to achieve the critical view of the MPO will foster the goal of safe MIS hernia repair, no matter which minimally invasive technique is employed. Keywords Inguinal hernia • Minimally invasive surgery • Laparoscopy • Robotic • Critical view • Golden rules Although laparoscopic inguinal hernia repair was first introduced over 27 years ago as an alternative to conventional open inguinal hernia repairs, the majority of hernias worldwide are still repaired with an open anterior approach [1, 2]. Despite multiple peer-reviewed studies demonstrating that the approach is associated with postoperative benefits and can be safely duplicated by surgeons around the world, the growth of the technique has remained flat until very recently

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Robotic-assisted laparoscopic groin hernia repair: observational case-control study on the operative time during the learning curve

Cited by 67 publications

References 15 publications

Learning curve analysis of robotic transabdominal preperitoneal inguinal hernia repair

Learning curve analysis of robotic transabdominal preperitoneal inguinal hernia repair

Novel robot‐assisted laparoscopic total extra‐peritoneal repair with primary fascial closure plus pre‐peritonea mesh for large groin defects

Ten golden rules for a safe MIS inguinal hernia repair using a new anatomical concept as a guide

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