Sebastiano Spampatti1, Davide La Regina2, Ramon Pini2, Francesco Mongelli3, Paolo Gaffuri2, Iride Porcellini2, Andrea Romanzi4, Maria Marcantonio2. 1. Ente Ospedaliero Cantonale Department of Surgery, Ospedale Regionale Di Bellinzona E Valli, via Ospedale 12, 6500, Bellinzona, Switzerland. sebastiano.spampatti@eoc.ch. 2. Ente Ospedaliero Cantonale Department of Surgery, Ospedale Regionale Di Bellinzona E Valli, via Ospedale 12, 6500, Bellinzona, Switzerland. 3. Ente Ospedaliero Cantonale Department of Surgery, Ospedale Regionale Di Lugano, via Tesserete 46, 6900, Lugano, Switzerland. 4. Department of Surgery, Ospedale Valduce, Via Dante Alighieri 11, 22100, Como, Italy.
Abstract
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.
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.
Authors: Stavros A Antoniou; George A Antoniou; Detlef K Bartsch; Volker Fendrich; Oliver O Koch; Rudolph Pointner; Frank A Granderath Journal: Am J Surg Date: 2013-06-12 Impact factor: 2.565
Authors: Leigh Neumayer; Anita Giobbie-Hurder; Olga Jonasson; Robert Fitzgibbons; Dorothy Dunlop; James Gibbs; Domenic Reda; William Henderson Journal: N Engl J Med Date: 2004-04-25 Impact factor: 91.245