Laparoscopic Versus Robotic Trans Abdominal Preperitoneal Inguinal Hernia Repair: A Randomized Controlled Trial

Introduction Minimal invasive inguinal hernia repair (LIHR or RIHR) is a pivotal advancement, focusing on minimizing postoperative pain and recurrence rates. This randomized controlled trial aims to compare outcomes of laparoscopic and robotic TAPP inguinal hernia repair, hypothesizing superior outcomes with the robotic approach. Materials and Methods This study was a single-center based, open-labeled, parallel-arm randomized controlled trial including all consenting adult patients with uncomplicated inguinal hernia, presenting to, AIIMS Jodhpur between January 2022 and June 2023. Patients were randomized and allocated in a 2:1 ratio into two arms, laparoscopic and robotic groups respectively. The primary outcome, postoperative pain was assessed by using VAS at 3,6 and 12 hours, and secondary outcomes were operative duration, hospital length of stay, urinary retention, and other complications. Results The baseline characteristics are as below: The median (IQR) VAS at 3, 6 and 12 hours are as below: No statistically significant difference was found in VAS between the groups. The median (IQR) operative duration was as below: No statistically significant difference was noted in the overall operative duration between the groups. However, the peritoneal dissection time was significant in the robotic arm with a p-value of 0.008. No difference was noted in the length of hospital stay, postoperative urinary retention rates, and complication rates at 1-week and 4-week follow-up. Conclusions There is no statistically significant difference between robotic and laparoscopic TAPP inguinal hernia repair. While robotic TAPP shows reduced peritoneal dissection time, overall operative duration remains similar due to docking/undocking.