Robotic TAPP repair of lateral abdominal wall hernias: a multi-center experience
Michael R Freund1, Ephraim Katz2,3, Lauren Lahav4
1Department of General Surgery, Shaare Zedek Medical Center, The Hebrew University Faculty of Medicine, Jerusalem, Israel. mikifreund@hotmail.com.
Introduction:
Lateral hernias are uncommon and technically challenging defects, with limited data guiding optimal surgical management. Robotic repair has emerged as a promising approach, though evidence remains sparse and largely limited to small single center series. This study aimed to evaluate the feasibility and short to mid-term outcomes of robotic trans abdominal preperitoneal (TAPP) lateral hernia repair in a multi-center cohort.
Methods:
A retrospective multi-center study was conducted including consecutive adult patients undergoing robotic TAPP repair of lateral abdominal wall hernias. Hernias were classified according to the European Hernia Society classification. Demographics, operative details, and postoperative outcomes were analysed using descriptive statistics.
Results:
A total of 39 patients were included. The majority of hernias were incisional, with a predominance of left-sided defects. Median hernia size was within the moderate range, with most classified as L2-L3 and W2 according to EHS criteria. All procedures were completed robotically, predominantly using a preperitoneal approach. Median operative time was 150 min, with minimal blood loss in all cases and with no conversions. Overall morbidity was 23.1%, with most complications being minor. Major complications occurred in 7.7% of patients and included two bowel obstructions requiring reoperation. Median length of stay was 1 day, with low readmission and reoperation rates. At a median follow-up of 60.5 weeks, no recurrences were observed. Postoperative pain was low, with minimal opioid requirements.
Conclusions:
Robotic TAPP repair of lateral hernias appears to be a feasible approach for complex lateral abdominal wall defects, with acceptable early postoperative outcomes in this multi-center retrospective series. This multi-center series adds to the limited literature and supports the role of robotics in this challenging subset of hernias. Further studies with longer follow up are needed to assess long term durability.
