108 Efficacy and outcomes of Non-fixation Robotic TAPP for Inguinal hernia

Abstract Background Laparoscopic TAPP repair for inguinal hernia is a well-established technique resulting in reduced postoperative pain and earlier return to activities compared to open repair More recently, robotic platforms have allowed for robotic TAPP approach. Aim To interrogate patient outcomes after robotic TAPP compared to laparoscopic TAPP procedure. Method Retrospective analysis of a series of 21 unselected patients undergoing robotic TAPP in our institution in a 3-month period. Da Vinci XI system was used (3 arms) for Transabdominal preperitoneal approach using 3-D bard non-fixation technique. Peritoneal pocket closed with continuous 2.0 Vicryl suture. Results 21 patients identified (18M:3F), mean age of 61 years. 17 unilateral and 4 bilateral inguinal hernias were repaired. Operative times reduced with learning curve to average of 17 min of console time per case for last 5 cases. Average time from the operation to discharge was 8.5 hours, with 100% of patients being discharged within 24 hours of surgery. There were no immediate complications and no conversions to open. There was one case of postoperative groin pain at 30 days, treated with simple analgesia. Overall cost of robotic TAPP was comparable to laparoscopic TAPP, negating the use of disposable instruments or fixing device. Conclusion In our series RIHR yields favourable outcomes for patients compared to LIHR with reduced surgical time, complication rate, postoperative pain and length of hospital admission. This study highlights the significant advancement and benefits offered by robotic techniques in the field of hernia surgery, emphasising the need for increased utilisation of this procedure.