The Experience of Robot-assisted Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair Following Robot-assisted Laparoscopic Radical Prostatectomy: A Cohort Study

Abstract

BackgroundThere are no reports of robot-assisted laparoscopic transabdominal preperitoneal inguinal hernia repair (R-TAPP) for the patients who underwent robot-assisted laparoscopic radical prostatectomy (RALP). AimTo evaluate the feasibility and safety of R-TAPP in patients who underwent RALP for postprostatectomy inguinal hernia (PIH).MethodsThis is a prospective, single-center retrospective cohort study. R-TAPP was conducted in 74 consecutive patients from September 2016 to March 2020. Except for women and patients who underwent previous abdominal surgery, 70 patients were classified into two groups based on the absence or presence of PIH (PIH group or non-PIH group). The data were retrospectively compared to those who had not undergone RALP.ResultsSeventy patients were reviewed. Among them, 22.9% had previously undergone RALP. We identified 22 lesions in 16 patients (unilateral in 10; bilateral in 6) in the PIH group, and 67 lesions in 54 patients (unilateral in 41; bilateral in 13) in the non-PIH group. The PIH group showed a longer median operation time compared to the non-PIH group. However, postoperative complications—including seroma formation, hematoma, and surgical site infections—were not significantly different between the groups. There were no recorded vascular, bladder, or spermatic cord injuries in either group. There was no conversion to laparoscopic or open surgery in either group. The estimated blood loss was small, and hospitalization duration was one day in all cases. Moreover, there were no hernia recurrences within the 90-day follow-up period in either group.ConclusionR-TAPP seem to be a feasible and safe approach for inguinal hernia repair, even in patients who underwent RALP for prostate cancer.