Initial Experience of Robot-Assisted Transabdominal Preperitoneal (TAPP) Inguinal Hernia Repair by a Single Surgeon in South Korea
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Patients
2.3. Statistics and Ethical Considerations
2.4. Cumulative Sum (CUSUM) Analysis
2.5. Surgical Procedure for Robotic-Assisted TAPP Inguinal Hernia Repair
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | All (n = 100) | Laparoscopic TAPP (n = 50) | Robotic TAPP (n = 50) | p-Value |
---|---|---|---|---|
Age (years, mean ± SD) | 59.4 ± 15.2 | 64.4 ± 14.8 | 54.4 ± 14.0 | 0.001 |
BMI a | 24.3 ± 2.9 | 23.8 ± 2.9 | 24.8 ± 3.0 | 0.116 |
Gender (%) | ||||
Male | 99 (99%) | 49 (98%) | 50 (100%) | 0.315 |
Female | 1 (1%) | 1 (2%) | 0 (0%) | |
ASA b score | 2.2 ± 0.5 | 2.3 ± 0.6 | 2.0 ± 0.4 | 0.002 |
CLASS I (%) | 5 (5%) | 2 (2%) | 3 (6%) | 0.003 |
CLASS II (%) | 73 (60%) | 30 (60%) | 43 (86%) | |
CLASS III (%) | 22 (100%) | 18 (36%) | 4 (8%) | |
Comorbidities (%) | ||||
HTN c | 44 (43%) | 30 (60%) | 14 (28%) | 0.001 |
DM d | 14 (13%) | 9 (18%) | 5 (10%) | 0.249 |
Cardiovascular | 15 (15%) | 10 (20%) | 5 (10%) | 0.161 |
Pulmonary | 10 (10%) | 7 (14%) | 3 (6%) | 0.182 |
Renal | 0 (0%) | 0 (0%) | 0 (0%) | 1 |
Liver | 6 (6%) | 3 (6%) | 3 (6%) | 1 |
Cerebral | 4 (4%) | 3 (6%) | 1 (2%) | 0.307 |
Other cancer history | 10 (10%) | 6 (12%) | 4 (8%) | 0.505 |
BPH e | 20 (20%) | 12 (24%) | 8 (16%) | 0.317 |
Smoking | 34 (34%) | 15 (30%) | 19 (38%) | 0.398 |
Alcohol | 42 (42%) | 20 (40%) | 22 (44%) | 0.685 |
Steroid use | 0 (0%) | 0 (0%) | 0 (0%) | 1 |
Variables | All (n = 100) | Laparoscopic TAPP (n = 50) | Robotic TAPP (n = 50) | p-Value |
---|---|---|---|---|
Operation time (minutes, mean ± SD) | 30.8 ± 11.1 | 31.5 ± 10.3 | 30.2 ± 11.9 | 0.56 |
Conversion rate (%) (Open or Laparoscopic) | 0 (0%) | 0 (0%) | 0 (0%) | 1 |
Cost of surgery (USD a) | 209.6 ± 27.5 | 3814.8 ± 172.9 | <0.001 | |
Type of hernia (%) | 0.829 | |||
Indirect only | 87 (87%) | 44 (88%) | 43 (86%) | |
Direct only | 7 (7%) | 3 (6%) | 4 (8%) | |
Combined direct and indirect | 3 (3%) | 1 (2%) | 2 (4%) | |
Femoral | 1 (1%) | 0 (0%) | 1 (2%) | |
Spigelian | 1 (1%) | 1 (2%) | 0 (0%) | |
Hernia site (%) | 0.483 | |||
Right | 61 (61%) | 32 (64%) | 29 (58%) | |
Left | 31 (31%) | 13 (26%) | 18 (36%) | |
Bilateral | 8 (8%) | 5 (10%) | 3 (6%) | |
Previous contralateral hernia (%) | 10 (10%) | 4 (8%) | 6 (12%) | 0.505 |
Complex hernia (%) | ||||
Recurrent hernia | 8 (8%) | 5 (10%) | 3 (6%) | 0.461 |
Incarceration | 9 (9%) | 4 (8%) | 5 (10%) | 0.727 |
Prostatectomy history | 8 (8%) | 6 (12%) | 2 (4%) | 0.14 |
Variables | All (n = 100) | Laparoscopic TAPP (n = 50) | Robotic TAPP (n = 50) | p-Value |
---|---|---|---|---|
Hospital stay (days, mean ± SD) | 3.4 ± 1.6 | 3.5 ± 2.2 | 3.4 ± 0.6 | 0.658 |
VAS a score | ||||
Operation day (0–10, mean ± SD) | 4.7 ± 1.0 | 4.6 ± 1.1 | 4.8 ± 0.9 | 0.243 |
Postoperative 1 day (0–10, mean ± SD) | 2.7 ± 0.7 | 2.9 ± 0.5 | 2.5 ± 0.7 | 0.015 |
Readmission within 30 days (%) | 0 (0%) | 0 (0%) | 0 (0%) | 1 |
Hernia recurrence (%) | 1 (1%) | 1 (2%) | 0 (0%) | 0.315 |
Postoperative outcome (%) | ||||
Infection (Surgical site, Mesh) | 0 (0%) | 0 (0%) | 0 (0%) | 1 |
Seroma | 2 (2%) | 2 (4%) | 0 (0%) | 0.153 |
Hematoma | 4 (4%) | 3 (6%) | 1 (2%) | 0.307 |
Prolonged ileus | 0 (0%) | 0 (0%) | 0 (0%) | 1 |
Bowel obstruction | 0 (0%) | 0 (0%) | 0 (0%) | 1 |
Bladder injury | 0 (0%) | 0 (0%) | 1 (2%) | 0.315 |
Urinary retention | 8 (8%) | 5 (10%) | 3 (6%) | 0.461 |
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Choi, Y.S.; Kim, K.D.; Choi, M.S.; Heo, Y.S.; Yi, J.W.; Choe, Y.-M. Initial Experience of Robot-Assisted Transabdominal Preperitoneal (TAPP) Inguinal Hernia Repair by a Single Surgeon in South Korea. Medicina 2023, 59, 582. https://doi.org/10.3390/medicina59030582
Choi YS, Kim KD, Choi MS, Heo YS, Yi JW, Choe Y-M. Initial Experience of Robot-Assisted Transabdominal Preperitoneal (TAPP) Inguinal Hernia Repair by a Single Surgeon in South Korea. Medicina. 2023; 59(3):582. https://doi.org/10.3390/medicina59030582
Chicago/Turabian StyleChoi, Yun Suk, Kyeong Deok Kim, Moon Suk Choi, Yoon Seok Heo, Jin Wook Yi, and Yun-Mee Choe. 2023. "Initial Experience of Robot-Assisted Transabdominal Preperitoneal (TAPP) Inguinal Hernia Repair by a Single Surgeon in South Korea" Medicina 59, no. 3: 582. https://doi.org/10.3390/medicina59030582