Inguinal hernia TAPP repair using Senhance® robotic platform: first multicenter report from the TRUST registry.

PURPOSE: The purpose of this article was to provide feasibility and safety results of robotic transabdominal preperitoneal inguinal hernia repair (Robotic TAPP). METHODS: We included 271 cases of robotic inguinal hernia TAPP repair using the Senhance® robotic platform from four different centers between March 2017 and March 2020. Key data points were intraoperative and postoperative complication rate, operating time, length of hospital stay, postoperative pain score and time required to get back to a daily routine that were inserted in the TransEnterix European Patient Registry for Robotic assisted Laparoscopic Procedures in Urology, Abdominal Surgery, Thoracic and Gynecologic Surgery (TRUST). RESULTS: We report 203 cases of unilateral and 68 cases of bilateral inguinal hernia repairs. Mean operative time was 74 ± 35 min (range 32-265 min), postoperative complications occurred in five (1.85%) cases, the intraoperative complication rate was five (1.85%). The average subjective patient-related pain score after the procedure was 3 ± 1.9 (range 1-9), length of hospital stay was 39 ± 28 h (range 4-288 h), and recovery time was 9.65 ± 8 days (range 1-36 days). CONCLUSION: Robotic inguinal hernia TAPP repair shows inspiring results. It is a safe and doable procedure. However, cost analysis should be performed in future to show the superiority over other techniques.

Neuron numbers in sensory cortices of five delphinids compared to a physeterid, the pygmy sperm whale.

With its large mass and enormous gyrification, the neocortex of whales and dolphins has always been a challenge to neurobiologists. Here we analyse the relationship between neuron number per cortical unit in three different sensory areas and brain mass in six different toothed whale species, five delphinids and one physeterid. Cortex samples, including primary cortical areas of the auditory, visual, and somatosensory systems were taken from both hemispheres of brains fixed in 10% buffered formalin. The samples were embedded in paraffin, sectioned at 25 microm thickness and stained with cresyl violet. Because cortical thickness varies among toothed whale species, cell counts were done in cortical units measuring 150mum in width, 25 microm in thickness, and extending from the pial surface to the white matter. By arranging the delphinid brains according to their total mass, 834-6052 g, we found decreasing neuron numbers in the investigated areas with increasing brain mass. The pigmy sperm whale (Kogia breviceps), a physeterid with an adult brain weight of 1000 g had a distinctly lower neuron number per cortical unit. As had been expected, an increase in adult brain weight in delphinid cetaceans (family Delphinidae) is not correlated with an increase in neuron number per cortical unit.