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Abstract Background Robot-assisted surgery, particularly RTAPP utilizing the da Vinci Surgical System, has been recognized for its potential to enhance surgical precision in inguinal hernia repairs. In December 2018, our hospital established a time-limited task protocol alongside initiating RTAPP. This protocol divides the surgery into three phases: peritoneal dissection, mesh placement, and peritoneal suturing, aiming to enhance patient safety and surgical efficiency. Methods This retrospective review analyzed RTAPP procedures from December 2018 through November 2023, assessing operative times, complication rates, recurrence rates, adherence to our innovative time-limited protocol, and the progression of the surgical learning curve. Results The analysis included 66 patients (101 lesions; 35 bilateral, 31 unilateral), predominantly male (62 males, 4 females), with a median age of 73 years and a BMI of 24.2 kg/m². Lesions were categorized into 55 indirect and 46 direct types. Median operative and console times were 126 and 88 minutes, respectively. Complications were minimal, including one seroma, one SSI (both Clavien-Dindo grade I), and one injury to the inferior epigastric artery, all adhering strictly to the protocol. The learning curve demonstrated stabilization after 38 procedures. Discussion Our protocol for RTAPP significantly improved early safety and efficiency. Strategic planning and focused training were essential for integrating this technology effectively. Conclusions RTAPP has effectively met the challenges of inguinal hernia repair for introduce, enhancing surgical precision and patient safety. The structured protocol facilitated rapid proficiency among surgeons, demonstrating the technique's significant potential for improving robotic-assisted surgeries.
Saito et al. (Wed,) studied this question.