Short-term outcomes of robotic eTEP versus TAPP for ventral hernia repair: insights from a propensity-matched cohort

Robotic ventral hernia repair (rVHR) is an advanced form of minimally invasive surgery that offers enhanced precision, reduced complications, and faster recovery time. However, direct comparisons between enhanced-view totally extraperitoneal (eTEP) and transabdominal preperitoneal (TAPP) approaches remain limited. This study aimed to compare the safety and clinical outcomes of eTEP and TAPP in rVHR. In this retrospective cohort study, 117 patients underwent rVHR (82 eTEP, 35 TAPP) between 2023 and 2024. Propensity score matching (PSM) (1:1) balanced baseline characteristics, resulting in 33 patients per group. Patient demographics, operative data, and postoperative outcomes were collected from electronic medical records. Statistical analyses were conducted using SPSS, with statistical significance defined as p < 0.05. Following matching, eTEP demonstrated significantly longer operative times (median 115 vs. 83 min, p = 0.004) and larger mesh sizes (420 cm² vs. 195 cm², p = 0.001). Surgical drains were more frequently used in eTEP (48.4% vs. 3%, p = 0.001). Postoperative outcomes, length of hospital stay, and pain scores did not differ significantly between the groups. Surgical site occurrences (SSOs) showed no significant difference between groups (18.1% eTEP vs. 9% TAPP, p = 0.475). Both eTEP and TAPP are safe and effective robotic approaches for ventral hernia repair with comparable clinical outcomes. The longer operative time and larger mesh size in eTEP suggests its preferential use in more complex hernia cases requiring detailed anatomical reconstruction.