Robotic-assisted laparoscopic groin hernia repair: observational case-control study on the operative time during the learning curve.
Surg Endosc
; 32(12): 4850-4859, 2018 12.
Article
em En
| MEDLINE
| ID: mdl-29766308
ABSTRACT
BACKGROUND:
Robotic groin hernia repair (r-TAPP) is demonstrating rapid adoption in the US. Barriers in Europe include low availability of robotic systems to general surgeons, cost of robotic instruments, and the perception of longer operative time.METHODS:
Patients undergoing r-TAPP in our start-up period were prospectively entered in the EuraHS database and compared to laparoscopic TAPP (l-TAPP) performed by the same surgeon within the context of two other prospective studies. Operations were performed with the daVinci Xi robot and the primary endpoint was skin-to-skin operative time.RESULTS:
Following proctoring in September 2016 by US surgeons, 50 r-TAPP (34 unilateral and 16 bilateral) procedures have been performed up to January 2017. Mean operative time for unilateral r-TAPP was 54 min, with a decrease from 63 min for the first tertile to 44 min for the third tertile. For unilateral l-TAPP, the mean operative time was 45 min. Mean operative time for bilateral r-TAPP was 78 min, with a decrease from 90 min for the first half to 68 min for the second half. For bilateral l-TAPP, the mean operative time was 61 min. There were no intraoperative complications and no conversions to conventional laparoscopy or open surgery. The operation was performed as an outpatient in 67% of cases. Urinary retention requiring urinary catheterization was the only early postoperative complication noted in 5 patients (10.2%). At 4 week follow-up, 7 patients (14.3%) had an asymptomatic seroma, but no other complications were seen.CONCLUSION:
Robotic TAPP was associated with a rapid reduction in operative time during our learning curve and afterwards the operative time to perform a robotic TAPP equals the operative time to perform a laparoscopic TAPP, both for unilateral and for bilateral groin hernia repairs. No complications related to the introduction of robotic-assisted laparoscopic groin hernia repair were observed.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Laparoscopia
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Curva de Aprendizado
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Duração da Cirurgia
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Procedimentos Cirúrgicos Robóticos
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Hérnia Inguinal
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article