Three-point mesh fixation in robot-assisted transabdominal preperitoneal (R-TAPP) repair of 208 inguinal hernias: preliminary results of a single-center consecutive series

• Published in: Langenbeck's archives of surgery 2022-09, Vol.407 (6), p.2555-2561
• Main Authors: Spampatti, Sebastiano, La Regina, Davide, Pini, Ramon, Mongelli, Francesco, Gaffuri, Paolo, Porcellini, Iride, Romanzi, Andrea, Marcantonio, Maria
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Cardiac Surgery; General Surgery; Medicine; Medicine & Public Health; Original Article; Thoracic Surgery; Traumatic Surgery; Vascular Surgery
• ISSN: 1435-2451; 1435-2451
• DOI: 10.1007/s00423-022-02542-4

Purpose The aim of this study was to assess the efficacy of our mesh fixation technique in robot-assisted transabdominal preperitoneal inguinal hernia repair (R-TAPP). The primary outcome was the recurrence rate. Secondary outcomes were postoperative pain, chronic pain, and return to normal activities. Methods Between January 2018 and December 2019, we performed 208 consecutive R-TAPP in 161 patients and the mesh was fixed by three intracorporeal stiches using a Polyglactin 910 (Vicryl®) 3–0 suture. Patients were followed up at 10 and 30 days after surgery with a clinical evaluation for detection of early complications, postoperative pain, need for analgesics, return to normal activities, and satisfaction rate. Patients were further followed up at study conclusion in February 2021 for recurrence and chronic pain detection. Results Painkillers were stopped by 57% of the patients after the first postoperative day and by 96% after 1 week. Chronic pain (> 3 months after surgery) was observed in three patients (1.8%) and only one of them was treated with percutaneous ilioinguinal-iliohypogastric nerve infiltration. After a mean follow-up of 24.0 ± 6.7 months, only 1 recurrence (0.48%) was clinically detected and confirmed by a CT-scan. Conclusions The 3-point mesh fixation technique is feasible during robot-assisted TAPP repair for inguinal hernia and seems to be a viable alternative to other fixation methods. Further long-term controlled investigations are needed to understand if this technique is effective in influencing recurrence and chronic pain rates.