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Learning curve of robotic inguinal hernia repair in the hands of an experienced laparoscopic surgeon: a comparative
Katz Ephraim1,2, Benvenisti Haggai1, Adileh Mohammad1
1Department of General and Oncological Surgery-Surgery C, The Chaim Sheba Medical Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Ramat Gan, Israel.
Background:
Since its introduction, robotic surgery has been utilized in different types of surgeries over various specialties. However, studies done thus far comparing robotic (Rob. IHR) and laparoscopic inguinal hernia repair (Lap. IHR) yielded contrasting results.
Objectives:
This study evaluates the outcomes of adapting the robotic platform for IHR by a single experienced surgeon, comparing it to laparoscopic inguinal hernia repair (Lap. IHR) performed at same time period.
Methods:
Retrospective analysis of a prospectively maintained database including all patients that underwent IHR between 2017 and 2019 (n = 188) was performed. Analyzed data included patient demographics, hernia characteristics, intraoperative data and postoperative outcomes.
Results:
Patients (n = 188) underwent a total of 120 Rob. IHR and 157 Lap. IHR. Age, sex, BMI, ASA score and length of hospital stay were similar in both groups. Recurring hernias were repaired more often robotically (p = 0.001). Operative time was significantly longer using the robot. (78.8 ± 24 min vs 55.4 ± 17.4 min for unilateral) and (107.9 ± 30 min vs 62.6 ± 20.2 min for bilateral) Rob. IHR vs Lap. IHR respectively, p < 0.001. Rob. IHR operative time decreased while building a learning curve. Rates of simple and severe postoperative complications were similar, p = 0.414. Recurrence occurred once in Rob. IHR group (1.4%) and 3 times in the Lap. IHR (1.9%) (p = 0.642).
Conclusion:
Our series shows that Rob. IHR is safe with comparable outcomes to Lap. IHR even in early learning curve. Robotic inguinal hernia repair allows the buildup of a short, safe and efficacious robotic learning experience for the minimally invasive surgeons for future more complex robotic surgeries.
