TY - JOUR
T1 - Safety and short-term outcomes of robotic-assisted transabdominal preperitoneal repair for inguinal hernia in pioneering hospitals in Japan
T2 - A nationwide retrospective cohort study
AU - Okamoto, Nobuhiko
AU - Misawa, Takeyuki
AU - Shimada, Gen
AU - Saito, Takuya
AU - Takiguchi, Shuji
AU - Imamura, Kiyotaka
AU - Ohuchi, Masakazu
AU - Tanida, Tsukasa
AU - Watanobe, Ikuo
AU - Fujii, Tsutomu
AU - Takemasa, Ichiro
AU - Mizutani, Fumitoshi
AU - Matsubara, Taketo
AU - Hayakawa, Shunsuke
AU - Watanabe, Toru
AU - Okuya, Koichi
AU - Takahashi, Hideki
AU - Horikawa, Masahiro
AU - Wakabayashi, Go
N1 - Publisher Copyright:
© 2023 Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.
PY - 2024/1
Y1 - 2024/1
N2 - Introduction: We aimed to evaluate the safety and short-term outcomes of robotic-assisted transabdominal preperitoneal repair for inguinal hernia in 12 pioneering hospitals in Japan. Methods: Clinical data of patients who underwent robotic-assisted transabdominal preperitoneal repair between September 1, 2016, and December 31, 2021 were collected. Primary outcome measures were intra-operative adverse events and post-operative complications, whereas secondary outcomes were surgical outcomes, including chronic pain, recurrence, and learning curve. Results: In total, 307 patients were included. One case of inferior epigastric arterial injury was reported; no cases of bowel or bladder injury were reported. Thirty-five seromas were observed, including four (1.3%) cases that required aspiration. The median operative time of a unilateral case was 108 minutes (interquartile range: 89.8–125.5), and post-operative pain was rated 1 (interquartile range: 0–2) on the numerical rating scale. In complicated cases, such as recurrent inguinal hernias and robotic-assisted radical prostatectomy-associated hernias, dissection and suture were safely achieved, and no complications were observed, except for non-symptomatic seroma. All patients underwent robotic procedures, and there was no chronic post-operative inguinal pain, although one case of hernia recurrence was reported. Regarding the learning curve, plateau performance was achieved after 7–10 cases in terms of operative time (P <.001). Conclusion: Robotic-assisted transabdominal preperitoneal repair can be safely introduced in Japan. Regardless of the involvement of many surgeons, the mastery of robotic techniques was achieved relatively quickly. The advantage of robotic technology such as wristed instruments may expand the application of minimally invasive hernia repair for complicated cases.
AB - Introduction: We aimed to evaluate the safety and short-term outcomes of robotic-assisted transabdominal preperitoneal repair for inguinal hernia in 12 pioneering hospitals in Japan. Methods: Clinical data of patients who underwent robotic-assisted transabdominal preperitoneal repair between September 1, 2016, and December 31, 2021 were collected. Primary outcome measures were intra-operative adverse events and post-operative complications, whereas secondary outcomes were surgical outcomes, including chronic pain, recurrence, and learning curve. Results: In total, 307 patients were included. One case of inferior epigastric arterial injury was reported; no cases of bowel or bladder injury were reported. Thirty-five seromas were observed, including four (1.3%) cases that required aspiration. The median operative time of a unilateral case was 108 minutes (interquartile range: 89.8–125.5), and post-operative pain was rated 1 (interquartile range: 0–2) on the numerical rating scale. In complicated cases, such as recurrent inguinal hernias and robotic-assisted radical prostatectomy-associated hernias, dissection and suture were safely achieved, and no complications were observed, except for non-symptomatic seroma. All patients underwent robotic procedures, and there was no chronic post-operative inguinal pain, although one case of hernia recurrence was reported. Regarding the learning curve, plateau performance was achieved after 7–10 cases in terms of operative time (P <.001). Conclusion: Robotic-assisted transabdominal preperitoneal repair can be safely introduced in Japan. Regardless of the involvement of many surgeons, the mastery of robotic techniques was achieved relatively quickly. The advantage of robotic technology such as wristed instruments may expand the application of minimally invasive hernia repair for complicated cases.
KW - nationwide survey
KW - retrospective cohort study
KW - robotic inguinal hernia repair
KW - safety
KW - short-term outcomes
UR - http://www.scopus.com/inward/record.url?scp=85174550549&partnerID=8YFLogxK
U2 - 10.1111/ases.13251
DO - 10.1111/ases.13251
M3 - 学術論文
C2 - 37858296
AN - SCOPUS:85174550549
SN - 1758-5902
VL - 17
JO - Asian journal of endoscopic surgery
JF - Asian journal of endoscopic surgery
IS - 1
M1 - e13251
ER -