Introduction and Short-Term Outcomes of Robot-Assisted Transabdominal Preperitoneal Inguinal Hernia Repair at a Municipal Hospital by a Robotic Surgery Novice: A Single-Center, Observational Study

Robot-assisted transabdominal preperitoneal inguinal hernia repair (RTAPP) has been rapidly gaining popularity. However, RTAPP is currently limited to university hospitals and large medical centers and is performed mainly by experts in robotic surgery in Japan. In this study, we report the introduction of RTAPP at a municipal hospital by a robotic surgery novice and its short-term outcomes. We reviewed the data of patients with inguinal hernias who underwent RTAPP performed by a single surgeon between November 2023 and May 2024 and evaluated its safety and short-term outcomes. A comparative study was conducted using laparoscopic transabdominal preperitoneal inguinal hernia repair (LTAPP) performed by the same surgeon. We identified 13 lesions in 11 patients (unilateral in nine; bilateral in two) in the RTAPP group. The median operative time for unilateral cases was 137 (interquartile range [IQR], 75-200) min, with a console time of 98 (IQR, 40-156) min. The time for dissection, mesh placement, and peritoneal suturing was 67 (IQR, 44-79), 5 (IQR, 5-7), and 11 (IQR, 11-15) min, respectively. To date, no complications or recurrence has been observed in any of these cases. No significant difference in operational time was observed for unilateral cases between the RTAPP and LTAPP groups (137 min vs. 104; p = 0.129). Our study suggests that RTAPP is safe and feasible, even at a municipal hospital, by a robotic surgery novice. Moreover, RTAPP is comparable to LTAPP in terms of performance.